Diabetes & Metabolism Journal

Original Articles

Type 1 Diabetes
Familial Occurrence of Type 1 Diabetes Mellitus in Korean Children and Adolescents: A Multicenter Study: Hae Sang Lee, Hwa Young Kim, Mi Yang, Yun Jeong Kim, Hyun Wook Chae, Kyungchul Song, Aram Yang, Hyo-Kyoung Nam, Young-Jun Rhie, Eungu Kang, Mo Kyung Jung, Yoonha Lee, Sung Yoon Cho, Insung Kim, Minji Im, Moon Bae Ahn, Su Jin Park, Soo Yeun Sim, Yoo-Mi Kim, Young-Lim Shin, Yong Hee Hong, Junghwan Suh, Sujin Kim, Seo Jung Kim, Min Hyung Cho, Yong Hyuk Kim, Jieun Lee, Su Jin Kim, Jisun Park, Eun Young Joo, Myung Ji Yoo, Minsun Kim, Han Sol Kim, Han Hyuk Lim, Jung Eun Moon, Kyungmi Jang, Chan Jong Kim, Jaehyun Kim; Received November 13, 2025 Accepted January 23, 2026 Published online March 5, 2026; DOI: https://doi.org/10.4093/dmj.2025.1149 [Epub ahead of print]

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Data on the familial occurrence of type 1 diabetes mellitus (T1DM) in Korean pediatric populations are limited. This study evaluated the clinical characteristics of children with T1DM according to family history and estimated the T1DM prevalence among relatives.
Methods
We conducted a multicenter retrospective cohort study including patients aged ≤18 years newly diagnosed with T1DM at 18 university-affiliated hospitals in Korea between 2010 and 2024. The index child was defined as the first sibling diagnosed with T1DM and categorized according to the presence of affected parents or siblings. Familial T1DM prevalence was calculated for siblings, first-degree relatives, and twin pairs.
Results
Among 936 index children, 32 (3.4%) exhibited a T1DM family history. Compared with index children, subsequent-affected children presented with lower plasma glucose (300.0 mg/dL vs. 412.0 mg/dL, P=0.009) and glycosylated hemoglobin levels (10.4% vs. 12.6%, P<0.001), and a lower frequency of diabetic ketoacidosis (13.8% vs. 49.7%, P<0.001). Venous pH and serum bicarbonate levels were higher (7.4 vs. 7.3, P=0.005; 22.0 mmol/L vs. 17.0 mmol/L, P=0.004, respectively), whereas urine ketone levels were significantly lower (P<0.001). Sibling, first-degree relative, and twin-pair prevalence rates were 3.0% (23/779), 1.3% (34/2,651), and 42.9% (3/7), respectively.
Conclusion
In this multicenter Korean cohort, familial T1DM accounted for 3.4% of pediatric cases, which was lower than in Western populations. Subsequent-affected children exhibited milder metabolic decompensation at diagnosis than did index children, likely reflecting earlier recognition through family awareness and screening. These findings underscore the importance of early education and monitoring of at-risk relatives within affected families.

Basic and Translational Research
Pancreatic Islet Transplantation in Extrahepatic Sites: Evaluation of the Venous Sac in Large Mammal Models: Giorgi Kenchadze, Ivane Abiatari, Antonello Pileggi, Norma S. Kenyon, Dora M Berman, R. Damaris Molano, Konstantine Gogichaishvili, Revaz Otarashvili, Anzor Tchavtchavadze, Teona Midelashvili, Mariam Motsikulashvili, Camillo Ricordi, Thierry Berney, Ekaterine Berishvili; Received July 19, 2024 Accepted April 28, 2025 Published online September 8, 2025; DOI: https://doi.org/10.4093/dmj.2024.0400 [Epub ahead of print]

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The long-term clinical efficacy of intraportal islet transplantation is hampered by islet loss due to inflammation, oxidative stress, and insufficient vascularization. This study explores the venous sac as an alternative implantation site for islet transplantation in large animal models.
Methods
An immunosuppressed, diabetic cynomolgus monkey received allogeneic islet implants in its mesenteric venous sac, with metabolic assessments over 112 days. Dogs underwent islet autotransplantation into various venous sacs, with their glycemic control and other metabolic parameters monitored for 1 month.
Results
In an nonhuman primate, the mesenteric venous sac site improved glycemic control over a 3-month period, followed by destabilization of graft function. Histologic studies revealed healthy islets. The lack of mononuclear cell infiltrate suggested no signs of graft rejection. Saphenous venous sacs in dogs showed superior glycemic control, reduced insulin requirements, and maintained C-peptide levels, comparable to intraportal transplantation. Histological analyses confirmed islet preservation and graft vascularization in saphenous venous sacs.
Conclusion
This study provides preclinical evidence in support of the venous sac as a valuable extrahepatic location for pancreatic islet implantation. We found that the saphenous vein is a more effective site for islet engraftment than the mesenteric vein. This study offers potential benefits for improving the success rates of clinical islet transplantation.

Cardiovascular Risk/Epidemiology
High Waist-to-Height Ratio Increases the Risk of Cardiovascular Outcomes in Adults with Type 1 Diabetes Mellitus: A Nationwide Cohort Study: Kyeong-Jin Kim, Seohyun Kim, Rosa Oh, So Hyun Cho, Myunghwa Jang, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Ji Yoon Kim, Jae Hyeon Kim; Received March 4, 2025 Accepted June 21, 2025 Published online September 4, 2025; DOI: https://doi.org/10.4093/dmj.2025.0179 [Epub ahead of print]

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Central obesity contributes to an increased risk of cardiovascular disease (CVD) and mortality. The waist-to-height ratio (WHtR) is a practical marker of central obesity across sexes, ages, and ethnicities. However, its association with comprehensive cardiovascular (CV) outcomes in patients with type 1 diabetes mellitus (T1DM) remains unclear.
Methods
From a nationwide cohort database (2006–2020), 16,928 Korean adults with T1DM were included. Participants were categorized by their WHtR values using three criteria: a three-group classification (<0.5, 0.5 to <0.6, and ≥0.6) and two binary classifications (≥0.5 vs. <0.5; ≥0.6 vs. <0.6). The primary outcomes were composite CV events, including heart failure (HF), myocardial infarction (MI), ischemic stroke, and CVD-related deaths, with each component analyzed as a secondary outcome.
Results
During a median follow-up of 6.7 years (interquartile range, 5.2 to 8.8), 4,293 composite CV events occurred. Compared to the WHtR <0.5 group, the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the composite CV outcome were 1.14 (1.05 to 1.24) in the WHtR 0.5 to <0.6 group and 1.62 (1.38 to 1.90) in the WHtR ≥0.6 group (P for trend <0.001). Increasing trends in aHRs were noted with rising WHtR values for each component of the composite outcome. Compared to the WHtR <0.6 group, the aHRs for the WHtR ≥0.6 group were as follows: HF, 1.49 (95% CI, 1.28 to 1.73); MI, 1.31 (95% CI, 1.02 to 1.68); ischemic stroke, 1.24 (95% CI, 1.02 to 1.51); and CVD-related death, 2.09 (95% CI, 1.49 to 2.92).
Conclusion
High WHtR is associated with an increased risk of CV events in adults with T1DM.

Metabolic Risk/Epidemiology
Risk Factors and Survival Outcomes of Immune Checkpoint Inhibitor-Induced Type 1 Diabetes Mellitus: A Retrospective Cohort Study: Sang-hyeok Go, Yun Kyung Cho, Eun Hee Koh; Diabetes Metab J. 2026;50(1):115-126. Published online July 22, 2025; DOI: https://doi.org/10.4093/dmj.2024.0455

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Background
Immune checkpoint inhibitors (ICIs) have transformed the treatment of metastatic solid tumors; however, they induce immune-related adverse events, such as ICI-induced type 1 diabetes mellitus (ICI-T1DM), a rare but serious condition requiring lifelong insulin therapy. We aimed to identify the risk factors and survival outcomes associated with ICI-T1DM to optimize screening and mitigate adverse effects.
Methods
This retrospective cohort study analyzed 6,956 patients treated with ICIs at a tertiary care center between January 1, 2017, and February 28, 2023. ICI-T1DM was classified based on the need for persistent insulin therapy post-ICI and a C-peptide level <1.0 ng/mL. Patient demographics, clinical characteristics, treatment details, and survival outcomes were examined.
Results
ICI-T1DM was identified in 32 patients (0.46%) with a median onset time of 41 weeks. Significant risk factors included pre-existing diabetes (hazard ratio [HR], 2.352; 95% confidence interval [CI], 1.140 to 4.854), combination therapy with anti-programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) and anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors (HR, 3.666; 95% CI, 1.224 to 10.979), prolonged ICI treatment (≥12 weeks; HR, 4.789; 95% CI, 1.806 to 12.701), and thyroid dysfunction (HR, 4.027; 95% CI, 1.847 to 8.779). ICI-T1DM occurrence and thyroid dysfunction were associated with improved survival (HR, 0.224; 95% CI, 0.093 to 0.539; and HR, 0.616; 95% CI, 0.566 to 0.670).
Conclusion
Patients with pre-existing diabetes, combined anti–PD-1/PD-L1 and anti–CTLA-4 therapy, prolonged ICI treatment (≥12 weeks), and thyroid dysfunction are at high risk of developing ICI-T1DM. The observed survival benefits in patients with ICI-T1DM underscore the importance of aggressive glucose monitoring and patient education for early detection and management.

Citations

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The clinical spectrum and causal relationship assessment of checkpoint inhibitor‐associated autoimmune diabetes mellitus (CIADM): A retrospective observational study
Youjia Li, Kai Qu, Qianting Yang, Jinming Zhang, Yitao Xu, Haitao Wang, Kanghuai Zhang, Cheng Wang, Mohd H. Abdul‐Aziz, Jiao Xie
Diabetic Medicine.2026;[Epub] CrossRef
Complete response of sinonasal mucosal melanoma to nivolumab and ipilimumab combination therapy : A case report
Ikuya OMIZO, Kazuma HAYAKAWA, Akihiro ISHIGURO, Kenichiro MAE, Shoko FUKAURA, Kaoruko YOSHIDA, Ryokichi IRISAWA, Kazutoshi HARADA
Skin Cancer.2025; 40(3): 172. CrossRef

Technology/Device
Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study: Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(5):1040-1050. Published online April 28, 2025; DOI: https://doi.org/10.4093/dmj.2024.0804

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Background
This study aims to identify the status of continuous glucose monitoring (CGM) use among individuals with type 1 diabetes mellitus (T1DM) in South Korea and to investigate whether age-related disparities exist.
Methods
Individuals with T1DM receiving intensive insulin therapy were identified from the Korean National Health Insurance Cohort (2019–2022). Characteristics of CGM users and non-users were compared, and the prescription rates of CGM and sensor- augmented pump (SAP) or automated insulin delivery (AID) systems according to age groups (<19, 19–39, 40–59, and ≥60 years) were analyzed using chi-square tests. Glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CV) among CGM users were also examined.
Results
Among the 56,908 individuals with T1DM, 10,822 (19.0%) used CGM at least once, and 6,073 (10.7%) used CGM continuously. Only 241 (0.4%) individuals utilized either SAP or AID systems. CGM users were younger than non-users. The continuous prescription rate of CGM was highest among individuals aged <19 years (37.0%), followed by those aged 19–39 years (15.8%), 40–59 years (10.7%), and ≥60 years (3.9%) (P<0.001 for between-group differences). Among CGM users, HbA1c levels decreased from 8.7%±2.4% at baseline to 7.2%±1.2% at 24 months, and CV decreased from 36.6%±11.9% at 3 months to 34.1%±12.7% at 24 months.
Conclusion
Despite national reimbursement for CGM devices, the prescription rates of CGM remain low, particularly among older adults. Given the improvements in HbA1c and CV following CGM initiation, more efforts are needed to increase CGM utilization and reduce age-related disparities.

Citations

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Association of perceived diabetes stigma with time below range <3.0 mmol/L and anxiety in adults with type 1 diabetes using continuous glucose monitoring
Seohyun Kim, Soojin Park, Sang‐Man Jin, Jae Hyeon Kim, Gyuri Kim
Diabetic Medicine.2026;[Epub] CrossRef
Suboptimal adoption of diabetes technology despite coverage and the impact on glycemic outcomes in children and adolescents with type 1 diabetes in Hong Kong
Sarah Wing-yiu Poon, Kwong-tat Chan, Betty Wai-man But, Shirley Man-yee Wong, Wing-in Yam, Pik-to Cheung, Wing-shan See, Suk-yan Chan, Ho-chung Yau, Eunice Wai Yu Wong, Lap Ming Wong, Antony Chun-cheung Fu, Elaine Yin-wah Kwan, Janez Heung-ching Tsui, Sin
Journal of Pediatric Endocrinology and Metabolism.2026; 39(3): 251. CrossRef
Preliminary clinical outcomes and adoption of continuous glucose monitoring following reimbursement implementation in patients with type 1 diabetes in Thailand
Nichapa Yordsudueam, Nattakarn Numsriskulrat, Worapimon Lerdrassameethad, Pattayarporn Paleekul, Jutipond jitchana, Nitchakarn Laichuthai, Taninee Sahakitrungruang
Annals of Pediatric Endocrinology & Metabolism.2026; 31(1): 66. CrossRef
Challenges and Opportunities for Improving Care for Type 1 Diabetes in Older Adulthood
Anna R. Kahkoska, Joshua J. Neumiller, Anastasia-Stefania Alexopoulos, Amlan Barik, Elbert S. Huang, Lori M. Laffel, Naushira Pandya, Christine Slyne, Elena Toschi, Ruth S. Weinstock, Medha Munshi
Diabetes Care.2026; 49(4): 559. CrossRef
Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetologia.2026;[Epub] CrossRef
Sequential use of continuous glucose monitoring, with or without exercise trackers, significantly improves glycemic control in patients with type 2 diabetes
Anushka Lahiri, Suan Tee Lim, Htike Kyu, Yock Young Dan, Chin Meng Khoo
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
Endocrinology and Metabolism.2025;[Epub] CrossRef

Basic and Translational Research
Effects of CXCR1/2 Blockade with Ladarixin on Streptozotocin-Induced Type 1 Diabetes Mellitus and Peripheral Neuropathy and Retinopathy in Rat: Serena Boccella, Andrea Maria Morace, Cristina Giorgio, Francesca Guida, Michela Perrone, Iolanda Manzo, Carmela Belardo, Meghan Jones, Sabatino Maione, Andrea Aramini, Marcello Allegretti, Livio Luongo, Laura Brandolini; Diabetes Metab J. 2025;49(5):990-1005. Published online March 12, 2025; DOI: https://doi.org/10.4093/dmj.2024.0504

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Background
The CXC motif chemokine ligand 8 (CXCL8)-CXC motif chemokine receptor 1/2 (CXCR1/2) axis has been implicated in type 1 diabetes mellitus (T1DM). Its actions on non-immune cells may also contribute to T1DM-associated complications, including painful diabetic peripheral neuropathy (DPN) and diabetic retinopathy (DR).
Methods
We assessed the efficacy of early (4–8 weeks) or late (8–12 weeks) daily ladarixin (LDX) for the treatment of streptozotocin (STZ)-induced T1DM and the related complications of DPN or DR in male rats.
Results
Early LDX mitigated STZ-induced dysmetabolism (i.e., blood glucose, insulin), inflammation in dorsal root ganglion/ sciatic nerve (interleukin-1β and tumor necrosis factor-α expression) and mechanical allodynia and thermal hyperalgesia, indicative of DPN. Moreover, vitreous citrullinated histone H3 (CitH3) and plasma GRO/CINC1 (CXCL8) increase were attenuated. Late LDX failed to reverse STZ-induced changes in metabolic parameters (i.e., blood glucose, insulin, C-peptide, pancreatic β-cell number and function). Strikingly, even in the absence of an effect on glycemic control, late LDX mitigated STZ-induced mechanical allodynia and thermal hyperalgesia and vitreous (CXCL8, CitH3) and retinal (CXCL8, CXCR1/2, myeloperoxidase, CitH3) inflammatory/pro-angiogenic (vascular endothelial growth factor, CD34) signs of DR.
Conclusion
These data confirm the efficacy of LDX in STZ-induced T1DM and provide evidence of a protective effect also against DPN and onset of DR which is independent of its effect on β-cell functionality preservation and glycemic control.

Citations

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Beyond inflammation: the multifaceted therapeutic potential of targeting the CXCL8-CXCR1/2 axis in type 1 diabetes
Georgia Fousteri, Meghan Jones, Rubina Novelli, Serena Boccella, Laura Brandolini, Andrea Aramini, Paolo Pozzilli, Marcello Allegretti
Frontiers in Immunology.2025;[Epub] CrossRef
Ladarixin Potential over the Effects of IL-8 and of Serum from Patients with Abdominal Aortic Aneurysm on Human Aortic Cells
Lucia Spartano, Maria Lombardi, Vincenzo Ardita, Roberto Chiesa, Andrea Aramini, Marcello Allegretti, Domenico Baccellieri, Lidia De Filippis, Chiara Foglieni
Cells.2025; 14(21): 1713. CrossRef

Type 1 Diabetes
Global Burden of Type 1 Diabetes Mellitus Related Chronic Kidney Disease among Adolescents and Young Adults, and Projections to 2035: Results from the Global Burden of Disease Study 2021: Xiaoli Qu, Chongbin Liu, Lin Sun, Zhifeng Sheng; Diabetes Metab J. 2025;49(4):812-825. Published online March 10, 2025; DOI: https://doi.org/10.4093/dmj.2024.0544

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Background
Type 1 diabetes mellitus related chronic kidney disease (T1DM-CKD) presents a global health challenge, with unclear trends and patterns among adolescents and young adults. This study analyzed the burden and risk factors of T1DM-CKD in individuals aged 15 to 39 from 1990 to 2021 and predicted future trends.
Methods
Using data from the Global Burden of Disease (GBD) study 2021, we analyzed the prevalence, incidence, mortality, disability-adjusted life years (DALYs), and average annual percentage change (AAPC) of T1DM-CKD among youth across gender, sociodemographic index (SDI) areas, and data from 21 regions and 204 countries and territories. Risk factors were assessed and future trends were projected.
Results
Between 1990 and 2021, the global prevalence of T1DM-CKD aged 15 to 39 increased by 107.5% to 3.32 million, with an age-standardized prevalence rate (ASPR) of 111.44 per 100,000 (AAPC 1.33%). Incidence rose by 165.4% to 14,200, with an agestandardized incidence rate of 0.48 per 100,000 (AAPC 2.19%). However, age-standardized mortality rate (0.50 per 100,000, AAPC –0.87%) and age-standardized DALYs rate (30.61 per 100,000, AAPC –0.83%) decreased. ASPR increased across all SDI regions, especially in high-SDI countries. High fasting glucose remained the major risk factor influencing DALYs. By 2035, T1DM-CKD prevalence was projected to decrease to 2.86 million (ASPR 89.67 per 100,000).
Conclusion
The research revealed a global increase in T1DM-CKD among youth, with a shift towards younger onset and significant variations based on gender and location, emphasizing the importance of early prevention and management strategies for this demographic.

Citations

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Tracking three decades of type 1 diabetes‐related chronic kidney disease in East Asia: Burden, age–sex patterns, and quality of care index
Qiongfang Zhang, Huan Wang, Mei Sun, Yi Wu, Pan Xie
Journal of Diabetes Investigation.2026;[Epub] CrossRef
Global, regional, and national burden of chronic kidney disease and its associated anemia, 1990 to 2021 and predictions to 2050: an analysis of the global burden of disease study 2021
Qiao Qi, Yongtao Hu, Qiqi Shen, Kun Tang, Jie Yu, Yuexian Xu, Qingfeng Huang, Bingbing Hou, Zongyao Hao
BMC Nephrology.2025;[Epub] CrossRef
Global Burden of Severe Heart Failure Attributable to Chronic Kidney Disease in Diabetes Populations: A Systematic Analysis of the Global Burden of Disease Study 2021
Xingfang Wang, Dun Su
British Journal of Hospital Medicine.2025; 86(8): 1. CrossRef
Comprehensive epidemiological analysis of chronic kidney disease in adolescents and young adults (ages 10–24 years) from 1990 to 2021
Zheping Yuan, Li Wei, Xuezhong Gong, Jun Li
BMJ Open.2025; 15(10): e104587. CrossRef

Technology/Device
Comparison of Real-Time and Intermittently-Scanned Continuous Glucose Monitoring for Glycemic Control in Type 1 Diabetes Mellitus: Nationwide Cohort Study: Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(3):436-447. Published online February 27, 2025; DOI: https://doi.org/10.4093/dmj.2024.0160

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Background
This study compares the association between real-time continuous glucose monitoring (rtCGM) and intermittently- scanned CGM (isCGM) and glycemic control in individuals with type 1 diabetes mellitus (T1DM) in a real-world setting.
Methods
Using data from the Korean National Health Insurance Service Cohort, individuals with T1DM managed by intensive insulin therapy were followed at 3-month intervals for 2 years after the initiation of CGM. The glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CVs) of rtCGM and isCGM users were compared using independent two-sample t-test and a linear mixed model.
Results
The analyses considered 7,786 individuals (5,875 adults aged ≥19 years and 1,911 children and adolescents aged <19 years). Overall, a significant reduction in HbA1c level was observed after 3 months of CGM, and the effect was sustained for 2 years. The mean HbA1c level at baseline was higher in rtCGM users than in isCGM users (8.9%±2.7% vs. 8.6%±2.2%, P<0.001). However, from 3 to 24 months, rtCGM users had lower HbA1c levels than isCGM users at every time point (7.1%±1.2% vs. 7.5%±1.3% at 24 months, P<0.001 for all time points). In both adults and children, the greater reduction in HbA1c with rtCGM remained significant after adjusting for the baseline characteristics of the users. The CV also showed greater decrease with rtCGM than with isCGM.
Conclusion
In this large nationwide cohort study, the use of rtCGM was associated with a greater improvement in glycemic control, including HbA1c reduction, than the use of isCGM in both adults and children with T1DM.

Citations

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EMERGING DIGITAL TECHNOLOGIES IN MONITORING ENDOCRINE DISORDERS: CONTINUOUS GLUCOSE MONITORING SYSTEMS AND ARTIFICIAL INTELLIGENCE IN THE DIAGNOSIS OF POLYCYSTIC OVARY SYNDROME
Aleksandra Ćwirko-Godycka, Nikola Murawska, Michalina Chodór, Aleksandra Tomaszewska, Kinga Karczewska, Sonia Mojzyk, Maciej Kokoszka, Aleksandra Mierniczek, Natalia Dymel, Ryszard Feret
International Journal of Innovative Technologies in Social Science.2026;[Epub] CrossRef
Dementia Risk in Type 1 and 2 Diabetes: A Nationwide Population‐Based Comparison
Ji Eun Jun, Seohyun Kim, In‐Kyung Jeong, Jae Hyeon Kim
Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef
Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetologia.2026;[Epub] CrossRef
Beneficial Analysis for Glucose Variability by Continuous Glucose Monitoring (CGM)
Sanae Mima, Hiroshi Bando, Akemi Tamura, Yukari Okino, Takumi Yamada, Yoshiyuki Abe
Asploro Journal of Biomedical and Clinical Case Reports.2025; 8(2): 193. CrossRef
Islet Tissue Macrophages in Immunity Homeostasis and Type 1 Diabetes
Yan Wang, Zhaoran Wang, Wenya Diao, Tong Shi, Jiahe Xu, Tiantian Deng, Chaoying Wen, Jienan Gu, Tingting Deng, Sixuan Wang, Cheng Xiao
Clinical Reviews in Allergy & Immunology.2025;[Epub] CrossRef
Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications
Hwa Young Kim, Jaehyun Kim
Clinical and Experimental Pediatrics.2025; 68(11): 842. CrossRef
Dispositivi indossabili per la gestione del diabete
Filippo CARLUCCI, Antonella TABUCCHI, Marcello FIORINI, Lucrezia GALASSO, Alessandro TERRENI
Biochimica Clinica.2025;[Epub] CrossRef
Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
Endocrinology and Metabolism.2025;[Epub] CrossRef

Technology/Device
Efficacy and Safety of Automated Insulin Delivery Systems in Patients with Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis: Wenqi Fan, Chao Deng, Ruoyao Xu, Zhenqi Liu, Richard David Leslie, Zhiguang Zhou, Xia Li; Diabetes Metab J. 2025;49(2):235-251. Published online November 13, 2024; DOI: https://doi.org/10.4093/dmj.2024.0130

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Background
Automated insulin delivery (AID) systems studies are upsurging, half of which were published in the last 5 years. We aimed to evaluate the efficacy and safety of AID systems in patients with type 1 diabetes mellitus (T1DM).
Methods
We searched PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov until August 31, 2023. Randomized clinical trials that compared AID systems with other insulin-based treatments in patients with T1DM were considered eligible. Studies characteristics and glycemic metrics was extracted by three researchers independently.
Results
Sixty-five trials (3,623 patients) were included. The percentage of time in range (TIR) was 11.74% (95% confidence interval [CI], 9.37 to 14.12; P<0.001) higher with AID systems compared with control treatments. Patients on AID systems had more pronounced improvement of time below range when diabetes duration was more than 20 years (–1.80% vs. –0.86%, P=0.031) and baseline glycosylated hemoglobin lower than 7.5% (–1.93% vs. –0.87%, P=0.033). Dual-hormone full closed-loop systems revealed a greater improvement in TIR compared with hybrid closed-loop systems (–19.64% vs. –10.87%). Notably, glycemia risk index (GRI) (–3.74; 95% CI, –6.34 to –1.14; P<0.01) was also improved with AID therapy.
Conclusion
AID systems showed significant advantages compared to other insulin-based treatments in improving glucose control represented by TIR and GRI in patients with T1DM, with more favorable effect in euglycemia by dual-hormone full closedloop systems as well as less hypoglycemia for patients who are within target for glycemic control and have longer diabetes duration.

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A systematic literature review and meta‐analysis of real‐world evidence on commercially available automated insulin delivery systems in people with type 1 diabetes
Johannes Pöhlmann, Jayne Smith‐Palmer, Erik H. Serné, Anna‐Kaisa Tuomaala, Johan Jendle, Pratik Choudhary, Emanuele Bosi, Viswanathan Mohan, Tim van den Heuvel, Ohad Cohen, Richard F. Pollock
Diabetes, Obesity and Metabolism.2026; 28(S1): 13. CrossRef
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Jean‐Pierre Riveline, Jean‐Baptiste Julla, Elisabeth Bonnemaison, Michael Joubert, Sandrine Lablanche, Agnès Sola Gazagnes, Delphine Demarsy, Didier Gouet, Pauline Schaepelynck, Chloé Amouyal, Fabienne Dalla Vale, Anne Schletzer‐Mari, Sylvaine Clavel, Ann
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Mengyun Lei, Yongwen Zhou, Ying Ni, Zhiqin Lin, Qiongyan Lin, Ping Ling, Daizhi Yang, Wen Xu, Hongrong Deng, Jinhua Yan
Diabetes, Obesity and Metabolism.2026; 28(3): 1750. CrossRef
7. Diabetes Technology: Standards of Care in Diabetes—2026
Mandeep Bajaj, Rozalina G. McCoy, Kirthikaa Balapattabi, Raveendhara R. Bannuru, Natalie J. Bellini, Allison K. Bennett, Elizabeth A. Beverly, Kathaleen Briggs Early, Sathyavathi ChallaSivaKanaka, Justin B. Echouffo-Tcheugui, Brendan M. Everett, Rajesh Ga
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Brief Report

Technology/Device
Effectiveness of Predicted Low-Glucose Suspend Pump Technology in the Prevention of Hypoglycemia in People with Type 1 Diabetes Mellitus: Real-World Data Using DIA:CONN G8: Jee Hee Yoo, Ji Yoon Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(1):144-149. Published online August 28, 2024; DOI: https://doi.org/10.4093/dmj.2024.0039

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We evaluated the effectiveness of the predictive low-glucose suspend (PLGS) algorithm in the DIA:CONN G8. Forty people with type 1 diabetes mellitus (T1DM) who used a DIA:CONN G8 for at least 2 months with prior experience using pumps without and with PLGS were retrospectively analyzed. The objective was to assess the changes in time spent in hypoglycemia (percent of time below range [%TBR]) before and after using PLGS. The mean age, sensor glucose levels, glucose threshold for suspension, and suspension time were 31.1±22.8 years, 159.7±23.2 mg/dL, 81.1±9.1 mg/dL, and 111.9±79.8 min/day, respectively. Overnight %TBR <70 mg/dL was significantly reduced after using the algorithm (differences=0.3%, from 1.4%±1.5% to 1.1%±1.2%, P=0.045). The glycemia risk index (GRI) improved significantly by 4.2 (from 38.8±20.9 to 34.6±19.0, P=0.002). Using the PLGS did not result in a change in the hyperglycemia metric (all P>0.05). Our findings support the PLGS in DIA:CONN G8 as an effective algorithm to improve night-time hypoglycemia and GRI in people with T1DM.

Citations

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Scoping review of subcutaneous glucose monitoring techniques
Eva Hrubá, Jan Kubíček, Martin Augustynek
Measurement.2026; 261: 119940. CrossRef
Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2025; 49(5): 1040. CrossRef

Original Articles

Type 1 Diabetes
A New Tool to Identify Pediatric Patients with Atypical Diabetes Associated with Gene Polymorphisms: Sophie Welsch, Antoine Harvengt, Paola Gallo, Manon Martin, Dominique Beckers, Thierry Mouraux, Nicole Seret, Marie-Christine Lebrethon, Raphaël Helaers, Pascal Brouillard, Miikka Vikkula, Philippe A. Lysy; Diabetes Metab J. 2024;48(5):949-959. Published online March 22, 2024; DOI: https://doi.org/10.4093/dmj.2023.0166

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Background
Recent diabetes subclassifications have improved the differentiation between patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus despite several overlapping features, yet without considering genetic forms of diabetes. We sought to facilitate the identification of monogenic diabetes by creating a new tool that we validated in a pediatric maturity-onset diabetes of the young (MODY) cohort.
Methods
We first created the DIAgnose MOnogenic DIAbetes (DIAMODIA) criteria based on the pre-existing, but incomplete, MODY calculator. This new score is composed of four strong and five weak criteria, with patients having to display at least one weak and one strong criterion.
Results
The effectiveness of the DIAMODIA criteria was evaluated in two patient cohorts, the first consisting of patients with confirmed MODY diabetes (n=34) and the second of patients with T1DM (n=390). These DIAMODIA criteria successfully detected 100% of MODY patients. Multiple correspondence analysis performed on the MODY and T1DM cohorts enabled us to differentiate MODY patients from T1DM. The three most relevant variables to distinguish a MODY from T1DM profile were: lower insulin-dose adjusted A1c score ≤9, glycemic target-adjusted A1c score ≤4.5, and absence of three anti-islet cell autoantibodies.
Conclusion
We validated the DIAMODIA criteria, as it effectively identified all monogenic diabetes patients (MODY cohort) and succeeded to differentiate T1DM from MODY patients. The creation of this new and effective tool is likely to facilitate the characterization and therapeutic management of patients with atypical diabetes, and promptly referring them for genetic testing which would markedly improve clinical care and counseling, as well.

Citations

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Clinical Characterization of Atypical Diabetes: Insights from the GENEPEDIAB Study into the Spectrum Between Type 1 and Monogenic Diabetes
Antoine Harvengt, Gauthier Pirlot, Leyan Denizli, Zain Syed, Sophie Welsch, Dominique Beckers, Thierry Mouraux, Nicole Seret, Marie-Christine Lebrethon, Raphael Helaers, Pascal Brouillard, Miikka Vikkula, Philippe A. Lysy
Cells.2026; 15(5): 484. CrossRef
Genomic Insights into Unspecified Monogenic Forms of Diabetes and Their Associated Comorbidities: Implication for Treatment
Nadia Kheriji, Hamza Dallali, Mariem Gharbi, Asma Krir, Afef Bahlous, Melika Ben Ahmed, Faten Mahjoub, Abdelmajid Abid, Henda Jamoussi, Rym Kefi
Current Issues in Molecular Biology.2025; 47(12): 1055. CrossRef

Type 1 Diabetes
Optimal Coefficient of Variance Threshold to Minimize Hypoglycemia Risk in Individuals with Well-Controlled Type 1 Diabetes Mellitus: Jee Hee Yoo, Seung Hee Yang, Sang-Man Jin, Jae Hyeon Kim; Diabetes Metab J. 2024;48(3):429-439. Published online March 4, 2024; DOI: https://doi.org/10.4093/dmj.2023.0083

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Background
This study investigated the optimal coefficient of variance (%CV) for preventing hypoglycemia based on real-time continuous glucose monitoring (rt-CGM) data in people with type 1 diabetes mellitus (T1DM) already achieving their mean glucose (MG) target.
Methods
Data from 172 subjects who underwent rt-CGM for at least 90 days and for whom 439 90-day glycemic profiles were available were analyzed. Receiver operator characteristic analysis was conducted to determine the cut-off value of %CV to achieve time below range (%TBR)^{<54 mg/dL} <1 and =0.
Results
Overall mean glycosylated hemoglobin was 6.8% and median %TBR^{<54 mg/dL} was 0.2%. MG was significantly higher and %CV significantly lower in profiles achieving %TBR^{<54 mg/dL} <1 compared to %TBR^{<54 mg/dL} ≥1 (all P<0.001). The cut-off value of %CV for achieving %TBR^{<54 mg/dL} <1 was 37.5%, 37.3%, and 31.0%, in the whole population, MG >135 mg/dL, and ≤135 mg/dL, respectively. The cut-off value for %TBR^{<54 mg/dL}=0% was 29.2% in MG ≤135 mg/dL. In profiles with MG ≤135 mg/dL, 94.2% of profiles with a %CV <31 achieved the target of %TBR^{<54 mg/dL} <1, and 97.3% with a %CV <29.2 achieved the target of %TBR<54 mg/ dL=0%. When MG was >135 mg/dL, 99.4% of profiles with a %CV <37.3 achieved %TBR^{<54 mg/dL} <1.
Conclusion
In well-controlled T1DM with MG ≤135 mg/dL, we suggest a %CV <31% to achieve the %TBR^{<54 mg/dL} <1 target. Furthermore, we suggest a %CV <29.2% to achieve the target of %TBR^{<54 mg/dL} =0 for people at high risk of hypoglycemia.

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Glycemic variability before and during Ramadan fasting among adults with type 2 diabetes and hepatic cirrhosis: a prospective paired cohort using real‑time CGM
Sarah Firdausa, Irsan Hasan, Dicky L. Tahapary, Ignatius Bima Prasetya, Suharko Soebardi, Cleopas Martin Rumende, Hamzah Shatri, Cosphiadi Irawan, Wismandari Wisnu
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Time to redefine success in continuous glucose monitoring
Lara Albert, Ismael Capel, Mercedes Rigla
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Plasma C-Peptide Level and Continuous Glucose Monitoring-Derived Coefficient of Variation as a Predictable Risk Factor for Hypoglycemia in Koreans with Diabetes
Seung-Hyun Ko
Endocrinology and Metabolism.2025; 40(2): 198. CrossRef
Time in tight range and time in range for predicting the achievement of typical glucose management indicator and HbA1c targets
Seohyun Kim, Sang Ho Park, Jin A. Lee, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
Diabetologia.2025; 68(8): 1674. CrossRef
Associations of time in tight range, time in range, and glycated hemoglobin with albuminuria in type 1 diabetes: A cross-sectional study
Ji Yoon Kim, Seohyun Kim, Sang Ho Park, Jin A Lee, So Hyun Cho, Rosa Oh, Myunghwa Jang, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
Diabetes Research and Clinical Practice.2025; 226: 112325. CrossRef
When would I be surprised? Variability in predicted probability of survival for being “surprised” and “not surprised” to the surprise question
David Hui, Amy Ontai, Clark Andersen, John P. Maxwell, Yusuke Hiratsuka, Sang-Yeon Suh, Sun Hyun Kim, Eduardo Bruera
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Complications
Does the Relationship of the Autonomic Symptoms Questionnaire COMPASS 31 with Cardiovascular Autonomic Tests Differ between Type 1 and Type 2 Diabetes Mellitus?: Ilenia D’Ippolito, Marika Menduni, Cinzia D’Amato, Aikaterini Andreadi, Davide Lauro, Vincenza Spallone; Diabetes Metab J. 2024;48(6):1114-1125. Published online February 26, 2024; DOI: https://doi.org/10.4093/dmj.2023.0301

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Background
The aim was to investigate if autonomic symptoms questionnaire Composite Autonomic Symptom Score (COMPASS) 31 has different association with cardiovascular autonomic neuropathy (CAN) and diagnostic performance between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).
Methods
Seventy-nine participants with T1DM and 140 with T2DM completed COMPASS 31 before cardiovascular reflex tests (CARTs) for CAN, and assessment of symptoms, signs, vibration, and thermal perception thresholds for diabetic polyneuropathy (DPN) diagnosis.
Results
COMPASS 31 total weighted score (TWS) was similar in the two groups, but significantly associated with confirmed CAN only in T1DM (P=0.0056) and not T2DM group (P=0.1768) and correlated with CARTs score more strongly in T1DM (rho=0.356, P=0.0016) than in T2DM group (rho=0.084, P=0.3218) (P=0.016). Only in T1DM and not T2DM group, the area under the receiver operating characteristic curve (AUC) reached a fair diagnostic accuracy (>0.7) for confirmed CAN (0.73±0.07 vs. 0.61±0.08) and DPN (0.75±0.06 vs. 0.68±0.05), although without a significant difference. COMPASS 31 TWS (cut-off 16.44) reached acceptable diagnostic performance in T1DM, with sensitivity for confirmed CAN 81.2% and sensitivity and specificity for DPN 76.3% and 78%, compared to T2DM group (all <70%). AUC for DPN of orthostatic intolerance domain was higher in T1DM compared to T2DM group (0.73±0.05 vs. 0.58±0.04, P=0.027).
Conclusion
COMPASS 31 is more weakly related to CAN in T2DM than in T1DM, with a fair diagnostic accuracy for confirmed CAN only in T1DM. This difference supports a multifactorial origin of symptoms and should be considered when using COMPASS 31.

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Corneal confocal microscopy identifies early and definite diabetic cardiac autonomic neuropathy
Shazli Azmi, Maryam Ferdousi, Alise Kalteniece, Ioannis N Petropoulos, Uazman Alam, Georgios Ponirakis, Omar Asghar, Andrew Marshall, Andrew JM Boulton, Nathan Efron, Rayaz A Malik
Diabetes Research and Clinical Practice.2025; 224: 112172. CrossRef
Features of short-term heart rate variability in internally displaced people with type 2 diabetes mellitus
V.A. Serhiyenko, V.B. Sehin, V.I. Pankiv, A.A. Serhiyenko
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Article commentary on: ‘impact of autonomic dysfunction on cardiovascular outcomes among patients with ATTR cardiomyopathy: insights from the COMPASS-31’
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Monika Zawadka-Kunikowska, Mirosława Cieślicka, Jacek J. Klawe, Małgorzata Tafil-Klawe, Wojciech Kaźmierczak, Łukasz Rzepiński
Frontiers in Neuroscience.2024;[Epub] CrossRef

Basic Research
Extracellular Vimentin Alters Energy Metabolism And Induces Adipocyte Hypertrophy: Ji-Hae Park, Soyeon Kwon, Young Mi Park; Diabetes Metab J. 2024;48(2):215-230. Published online September 26, 2023; DOI: https://doi.org/10.4093/dmj.2022.0332

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Background
Previous studies have reported that oxidative stress contributes to obesity characterized by adipocyte hypertrophy. However, mechanism has not been studied extensively. In the current study, we evaluated role of extracellular vimentin secreted by oxidized low-density lipoprotein (oxLDL) in energy metabolism in adipocytes.
Methods
We treated 3T3-L1-derived adipocytes with oxLDL and measured vimentin which was secreted in the media. We evaluated changes in uptake of glucose and free fatty acid, expression of molecules functioning in energy metabolism, synthesis of adenosine triphosphate (ATP) and lactate, markers for endoplasmic reticulum (ER) stress and autophagy in adipocytes treated with recombinant vimentin.
Results
Adipocytes secreted vimentin in response to oxLDL. Microscopic evaluation revealed that vimentin treatment induced increase in adipocyte size and increase in sizes of intracellular lipid droplets with increased intracellular triglyceride. Adipocytes treated with vimentin showed increased uptake of glucose and free fatty acid with increased expression of plasma membrane glucose transporter type 1 (GLUT1), GLUT4, and CD36. Vimentin treatment increased transcription of GLUT1 and hypoxia-inducible factor 1α (Hif-1α) but decreased GLUT4 transcription. Adipose triglyceride lipase (ATGL), peroxisome proliferator-activated receptor γ (PPARγ), sterol regulatory element-binding protein 1 (SREBP1), diacylglycerol O-acyltransferase 1 (DGAT1) and 2 were decreased by vimentin treatment. Markers for ER stress were increased and autophagy was impaired in vimentin-treated adipocytes. No change was observed in synthesis of ATP and lactate in the adipocytes treated with vimentin.
Conclusion
We concluded that extracellular vimentin regulates expression of molecules in energy metabolism and promotes adipocyte hypertrophy. Our results show that vimentin functions in the interplay between oxidative stress and metabolism, suggesting a mechanism by which adipocyte hypertrophy is induced in oxidative stress.

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Review

Pathophysiology
Immune-Checkpoint Inhibitors-Induced Type 1 Diabetes Mellitus: From Its Molecular Mechanisms to Clinical Practice: Yun Kyung Cho, Chang Hee Jung; Diabetes Metab J. 2023;47(6):757-766. Published online July 24, 2023; DOI: https://doi.org/10.4093/dmj.2023.0072

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With the increasing use of immune-checkpoint inhibitors (ICIs), such as anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and anti-programmed cell death-1 (PD-1), for the treatment of malignancies, cases of ICI-induced type 1 diabetes mellitus (ICI-T1DM) have been reported globally. This review focuses on the features and pathogenesis of this disease. T1DM is an immune-related adverse event that occurs following the administration of anti-PD-1 or anti-programmed death ligand-1 (PDL1) alone or in combination with anti-CTLA-4. More than half of the reported cases presented as abrupt-onset diabetic ketoacidosis. The primary mechanism of ICI-T1DM is T-cell stimulation, which results from the loss of interaction between PD-1 and PD-L1 in pancreatic islet. The similarities and differences between ICI-T1DM and classical T1DM may provide insights into this disease entity. ICI-T1DM is a rare but often life-threatening medical emergency that healthcare professionals and patients need to be aware of. Early detection of and screening for this disease is imperative. At present, the only known treatment for ICI-T1DM is insulin injection. Further research into the mechanisms and risk factors associated with ICI-T1DM development may contribute to a better understanding of this disease entity and the identification of possible preventive strategies.

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Original Articles

Lifestyle
Clinical Effects of a Home Care Pilot Program for Patients with Type 1 Diabetes Mellitus: A Retrospective Cohort Study: Sejeong Lee, KyungYi Kim, Ji Eun Kim, Yura Hyun, Minyoung Lee, Myung-Il Hahm, Sang Gyu Lee, Eun Seok Kang; Diabetes Metab J. 2023;47(5):693-702. Published online June 22, 2023; DOI: https://doi.org/10.4093/dmj.2022.0170

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Background
Given the importance of continuous self-care for people with type 1 diabetes mellitus (T1DM), the Ministry of Health and Welfare of Korea launched a pilot program for chronic disease management. Herein, we applied a home care pilot program to people with T1DM to investigate its effects.
Methods
This retrospective cohort study was conducted at a single tertiary hospital (January 2019 to October 2021). A multidisciplinary team comprising doctors, nurses, and clinical nutritionists provided specialized education and periodically assessed patients’ health status through phone calls or text messages. A linear mixed model adjusting for age, sex, and body mass index was used to analyze the glycemic control changes before and after implementing the program between the intervention and control groups.
Results
Among 408 people with T1DM, 196 were enrolled in the intervention group and 212 in the control group. The reduction in glycosylated hemoglobin (HbA1c) after the program was significantly greater in the intervention group than in the control group (estimated marginal mean, –0.57% vs. –0.23%, P=0.008); the same trend was confirmed for glycoalbumin (GA) (–3.2% vs. –0.39%, P<0.001). More patients achieved the target values of HbA1c (<7.0%) and GA (<20%) in the intervention group than in the control group at the 9-month follow-up (34.5% vs. 19.6% and 46.7% vs. 28.0%, respectively).
Conclusion
The home care program for T1DM was clinically effective in improving glycemic control and may provide an efficient care option for people with T1DM, and positive outcomes are expected to expand the program to include more patients.

Citations

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Feasibility of a semiautomated, individualized coaching intervention for glycemic management in adults with type 1 diabetes: a pilot randomized controlled trial
Seohyun Kim, Minkyeong Kim, Sang Ho Park, Soojin Park, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Gyuri Kim
Journal of Endocrinological Investigation.2026;[Epub] CrossRef
Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetologia.2026;[Epub] CrossRef
Comparison of Real-Time and Intermittently-Scanned Continuous Glucose Monitoring for Glycemic Control in Type 1 Diabetes Mellitus: Nationwide Cohort Study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2025; 49(3): 436. CrossRef
ATUAÇÃO DE PROGRAMA DE ATENÇÃO DOMICILIAR NO CUIDADO AOS PORTADORES DE DIABETES MELLITUS
Selva Antônia da Conceição Teixeira Dantas, Ruth Silva Lima da Costa
Scientia Generalis.2025; 6(1): 276. CrossRef
Home care program with telemonitoring for patients undergoing peritoneal dialysis in South Korea: a cost-utility analysis
KyungYi Kim, Tae Hyun Kim, Jaeyong Shin, Suk-Yong Jang, Hyung Woo Kim, Beom Seok Kim, Sang Gyu Lee
Kidney Research and Clinical Practice.2025; 44(4): 651. CrossRef
The Impact of Home Care on Glycosylated Hemoglobin and Quality of Life in Type 2 Diabetes Patients Discharged After Surgery
Maryam Heidarpour, Lila Faridani, Mojtaba Akbari, Amir Shahzeydi, Hamid Melali, Parvaneh Abazari
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Clinical Efficacy of a Home-based Peritoneal Dialysis Management Program
Do Hyoung Kim, Hayne Cho Park, AJin Cho, Jeonghwan Lee, Ji Hyeon Park, Gang-Jee Ko, Ho Sik Shin, Won Min Hwang, Jinseog Kim, Young-Ki Lee
Kidney International Reports.2025; 10(11): 3874. CrossRef
Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2025; 49(5): 1040. CrossRef
Glycemic outcomes and patient satisfaction and self-management improves in transition from standard to virtual multidisciplinary care
Noga Minsky, Liat Arnon Klug, Tatyana Kolobov, Elizabeth Tarshish, Yuval Shalev Many, Aviva Lipsitz, Amna Jabarin, Nicole Morozov, Dania Halperin, Moshe Shalom, Rachel Nissanholtz-Gannot, Genya Aharon-Hananel, Amir Tirosh, Orly Tamir
Diabetes Research and Clinical Practice.2024; 209: 111587. CrossRef

Technology/Device
Glycemia according to the Use of Continuous Glucose Monitoring among Adults with Type 1 Diabetes Mellitus in Korea: A Real-World Study: You-Bin Lee, Minjee Kim, Jae Hyeon Kim; Diabetes Metab J. 2023;47(3):405-414. Published online March 6, 2023; DOI: https://doi.org/10.4093/dmj.2022.0032

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Background
We explored the association between continuous glucose monitoring (CGM) use and glycemia among adults with type 1 diabetes mellitus (T1DM) and determined the status of CGM metrics among adults with T1DM using CGM in the real-world.
Methods
For this propensity-matched cross-sectional study, individuals with T1DM who visited the outpatient clinic of the Endocrinology Department of Samsung Medical Center between March 2018 and February 2020 were screened. Among them, 111 CGM users (for ≥9 months) were matched based on propensity score considering age, sex, and diabetes duration in a 1:2 ratio with 203 CGM never-users. The association between CGM use and glycemic measures was explored. In a subpopulation of CGM users who had been using official applications (not “do-it-yourself” software) such that Ambulatory Glucose Profile data for ≥1 month were available (n=87), standardized CGM metrics were summarized.
Results
Linear regression analyses identified CGM use as a determining factor for log-transformed glycosylated hemoglobin. The fully-adjusted odds ratio (OR) and 95% confidence interval (CI) for uncontrolled glycosylated hemoglobin (>8%) were 0.365 (95% CI, 0.190 to 0.703) in CGM users compared to never-users. The fully-adjusted OR for controlled glycosylated hemoglobin (<7%) was 1.861 (95% CI, 1.119 to 3.096) in CGM users compared to never-users. Among individuals who had been using official applications for CGM, time in range (TIR) values within recent 30- and 90-day periods were 62.45%±16.63% and 63.08%±15.32%, respectively.
Conclusion
CGM use was associated with glycemic control status among Korean adults with T1DM in the real-world, although CGM metrics including TIR might require further improvement among CGM users.

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Minkyu Seo, Kyu Hyun Park, Ji Won Park, EunJeong Kim, Do young Shin, Eungu Kang, Hyo-Kyoung Nam, Young-Jun Rhie, Kee-Hyoung Lee
Annals of Pediatric Endocrinology & Metabolism.2025; 30(5): 268. CrossRef
Real-World Continuous Glucose Monitoring Data from a Population with Type 1 Diabetes in South Korea: Nationwide Single-System Analysis
Ji Yoon Kim, Sang-Man Jin, Sarah B. Andrade, Boyang Chen, Jae Hyeon Kim
Diabetes Technology & Therapeutics.2024; 26(6): 394. CrossRef
Accuracy and Safety of the 15-Day CareSens Air Continuous Glucose Monitoring System
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Guideline/Fact Sheet
Insulin Fact Sheet in Type 1 and 2 Diabetes Mellitus and Trends of Antidiabetic Medication Use in Insulin Users with Type 2 Diabetes Mellitus: 2002 to 2019: Jiyun Park, Gyuri Kim, Bong-Sung Kim, Kyung-Do Han, So Yoon Kwon, So Hee Park, You-Bin Lee, Sang-Man Jin, Jae Hyeon Kim; Diabetes Metab J. 2023;47(2):211-219. Published online February 7, 2023; DOI: https://doi.org/10.4093/dmj.2022.0346

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Background
This study investigated the trends of insulin use among Korean patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Changes in prescription of antidiabetic medications in T2DM patients taking insulin therapy were evaluated.
Methods
We analyzed data from the National Health Insurance Service database in Korea to evaluate the prevalence of insulin users and trends of insulin use in T1DM and T2DM patients from January 2002 to December 2019. We also investigated numbers and types of antidiabetic medications in insulin users with T2DM.
Results
The overall total number of insulin users increased from 2002 to 2019, reaching 348,254 for T2DM and 20,287 for T1DM in 2019 compared with 109,974 for T2DM and 34,972 for T1DM in 2002. The proportion of patients using basal analogs and short acting analogs have increased and those using human insulin, premixed insulin, or biphasic human insulin have decreased (rapid acting analogs: 71.85% and 24.12% in T1DM and T2DM, respectively, in 2019; basal analogs: 76.75% and 75.09% in T1DM and T2DM, respectively, in 2019). The use of other antidiabetic medication in addition to insulin increased for T2DM, especially in dual therapy, reaching up to 52.35% in 2019 compared with 16.72% in 2002.
Conclusion
The proportion of the patients using basal or rapid acting analogs increased among all insulin users in both T1DM and T2DM patients. Among patients with T2DM, the proportion of patients using antidiabetic medications in addition to insulin was significantly increased compared to those who used insulin alone.

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Review

Technology/Device
Advances in Continuous Glucose Monitoring and Integrated Devices for Management of Diabetes with Insulin-Based Therapy: Improvement in Glycemic Control: Jee Hee Yoo, Jae Hyeon Kim; Diabetes Metab J. 2023;47(1):27-41. Published online January 12, 2023; DOI: https://doi.org/10.4093/dmj.2022.0271

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Continuous glucose monitoring (CGM) technology has evolved over the past decade with the integration of various devices including insulin pumps, connected insulin pens (CIPs), automated insulin delivery (AID) systems, and virtual platforms. CGM has shown consistent benefits in glycemic outcomes in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) treated with insulin. Moreover, the combined effect of CGM and education have been shown to improve glycemic outcomes more than CGM alone. Now a CIP is the expected future technology that does not need to be worn all day like insulin pumps and helps to calculate insulin doses with a built-in bolus calculator. Although only a few clinical trials have assessed the effectiveness of CIPs, they consistently show benefits in glycemic outcomes by reducing missed doses of insulin and improving problematic adherence. AID systems and virtual platforms made it possible to achieve target glycosylated hemoglobin in diabetes while minimizing hypoglycemia, which has always been challenging in T1DM. Now fully automatic AID systems and tools for diabetes decisions based on artificial intelligence are in development. These advances in technology could reduce the burden associated with insulin treatment for diabetes.

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Original Articles

Type 1 Diabetes
Performance of Fast-Acting Aspart Insulin as Compared to Aspart Insulin in Insulin Pump for Managing Type 1 Diabetes Mellitus: A Meta-Analysis: Deep Dutta, Ritin Mohindra, Kunal Mahajan, Meha Sharma; Diabetes Metab J. 2023;47(1):72-81. Published online June 24, 2022; DOI: https://doi.org/10.4093/dmj.2022.0035

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Background
No meta-analysis has analysed efficacy and safety of fast-acting aspart insulin (FIAsp) with insulin pump in type 1 diabetes mellitus (T1DM).
Methods
Electronic databases were searched for randomised controlled trials (RCTs) involving T1DM patients on insulin pump receiving FIAsp in intervention arm, and placebo/active comparator insulin in control arm. Primary outcome was to evaluate changes in 1- and 2-hour post-prandial glucose (1hPPG and 2hPPG). Secondary outcomes were to evaluate alterations in percentage time with blood glucose <3.9 mmol/L (hypoglycaemia), time in range (TIR) blood glucose 3.9 to 10 mmol/L, insulin requirements and adverse events.
Results
Data from four RCTs involving 640 patients was analysed. FIAsp use in insulin pump was associated with significantly greater lowering of 1hPPG (mean difference [MD], –1.35 mmol/L; 95% confidence interval [CI], –1.72 to –0.98; P<0.01; I²=63%) and 2hPPG (MD, –1.19 mmol/L; 95% CI, –1.38 to –1.00; P<0.01; I²=0%) as compared to controls. TIR was comparable among groups (MD, 1.06%; 95% CI, –3.84 to 5.96; P=0.67; I²=70%). Duration of blood glucose <3.9 mmol/L was lower in FIAsp group, approaching significance (MD, –0.91%; 95% CI, –1.84 to 0.03; P=0.06; I²=0%). Total hypoglycaemic episodes (risk ratio [RR], 1.35; 95% CI, 0.55 to 3.31; P=0.51; I²=0%), severe hypoglycaemia (RR, 2.26; 95% CI, 0.77 to 6.66; P=0.14), infusion site reactions (RR, 1.35; 95% CI, 0.63 to 2.93; P=0.77; I²=0%), and treatment-emergent adverse events (RR, 1.13; 95% CI, 0.80 to 1.60; P=0.50; I²=0%) were comparable.
Conclusion
FIAsp use in insulin pump is associated with better post-prandial glycaemic control with no increased hypoglycaemia or glycaemic variability.

Citations

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A Pilot Study Evaluating Meal Timing, Macronutrient Composition, and Faster-Acting Insulin Aspart Versus Insulin Aspart on Postprandial Glycemia with the Medtronic Advanced Hybrid Closed-Loop System
Dale J. Morrison, Melissa H. Lee, Sara Vogrin, Declan Hennessy, Emma Netzer, Hannah M. Jones, Lesley Robinson, Carmel E. Smart, Natalie Kurtz, Anirban Roy, Benyamin Grosman, David O’Neal
Diabetes Technology & Therapeutics.2026; 28(1): 38. CrossRef
Role of Ultra-Rapid Acting Insulin in Managing Diabetes
Satish K. Garg, Zehra Haider, Christopher G. Parkin
Diabetes Technology & Therapeutics.2026;[Epub] CrossRef
Glycemic control metrics during exercise in children with type 1 diabetes treated with domestic insulin aspart biosimilars using a hybrid closed-loop system
V. V. Platonov, E. D. Nоskova, A. V. Kiyaev, V. Yu. Detkov
Meditsinskiy sovet = Medical Council.2026; (1): 116. CrossRef
Tips for successful use of commercial automated insulin delivery systems: An expert paper of the Italian working group on diabetes and technology
Sergio Di Molfetta, Antonio Rossi, Roberta Assaloni, Roberto Franceschi, Valeria Grancini, Vincenzo Guardasole, Andrea Enzo Scaramuzza, Antonietta Maria Scarpitta, Maddalena Trombetta, Angela Zanfardino, Riccardo Candido, Angelo Avogaro, Valentino Cherubi
Diabetes Research and Clinical Practice.2025; 223: 112117. CrossRef
Glycemic Management Across the Lifespan for People With Type 1 Diabetes: A Clinical Practice Guideline
Ilana J. Halperin, Brandy Wicklow, Shazhan Amed, Alanna Chambers, Charlotte Courage, Elizabeth Cummings, Patricia Kirkland, Dylan MacKay, Meranda Nakhla, Zubin Punthakee, Paul M. Ryan, Lindsay Sawatsky, Peter A. Senior, Bikrampal S. Sidhu, Alanna Weisman
Canadian Journal of Diabetes.2025; 49(1): 5. CrossRef
Ultra-rapid lispro or fast-acting aspart compared to standard insulin lispro and aspart using closed-loop insulin therapy: a systematic review and meta-analysis of randomized control trials
Mohamed Saad Rakab, Rahma Mogahed Rateb, Basel Hatem Elsalakawi, Bashar M. Al Zoubi, Abubakar Nazir, Mutaz Moath Abu-Laila, Abdelrahman Sherif Ghanem, Alaa Maamoun, Mohab Mattar, Basma Ataallah, Brian T. Layden, Abeer M. Mahmoud
Frontiers in Endocrinology.2025;[Epub] CrossRef
Burden and Coping Strategies of Hypoglycemia in People with Diabetes
Aris Liakos, Thomas Karagiannis, Ioannis Avgerinos, Apostolos Tsapas, Eleni Bekiari
Current Diabetes Reviews.2024;[Epub] CrossRef
Ultrafast-acting insulin: pharmacological properties and their impact on clinical aspects
L. A. Suplotova, A. Sh. Tilkiyan
Meditsinskiy sovet = Medical Council.2024; (13): 146. CrossRef
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Adrian H. Heald, Mike Stedman, John Warner-Levy, Lleyton Belston, Angela Paisley, Aleksandra Jotic, Nebojsa Lalic, Martin Gibson, Hellena H. Habte-Asres, Martin Whyte, Angus Forbes
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Indian Journal of Endocrinology and Metabolism.2023; 27(6): 467. CrossRef

Type 1 Diabetes
Identification of Key Genes and Pathways in Peripheral Blood Mononuclear Cells of Type 1 Diabetes Mellitus by Integrated Bioinformatics Analysis: Xing Li, Mingyu Liao, Jiangheng Guan, Ling Zhou, Rufei Shen, Min Long, Jiaqing Shao; Diabetes Metab J. 2022;46(3):451-463. Published online April 1, 2022; DOI: https://doi.org/10.4093/dmj.2021.0018

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Background
The onset and progression of type 1 diabetes mellitus (T1DM) is closely related to autoimmunity. Effective monitoring of the immune system and developing targeted therapies are frontier fields in T1DM treatment. Currently, the most available tissue that reflects the immune system is peripheral blood mononuclear cells (PBMCs). Thus, the aim of this study was to identify key PBMC biomarkers of T1DM.
Methods
Common differentially expressed genes (DEGs) were screened from the Gene Expression Omnibus (GEO) datasets GSE9006, GSE72377, and GSE55098, and PBMC mRNA expression in T1DM patients was compared with that in healthy participants by GEO2R. Gene Ontology, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and protein-protein interaction (PPI) network analyses of DEGs were performed using the Cytoscape, DAVID, and STRING databases. The vital hub genes were validated by reverse transcription-polymerase chain reaction using clinical samples. The disease-gene-drug interaction network was built using the Comparative Toxicogenomics Database (CTD) and Drug Gene Interaction Database (DGIdb).
Results
We found that various biological functions or pathways related to the immune system and glucose metabolism changed in PBMCs from T1DM patients. In the PPI network, the DEGs of module 1 were significantly enriched in processes including inflammatory and immune responses and in pathways of proteoglycans in cancer. Moreover, we focused on four vital hub genes, namely, chitinase-3-like protein 1 (CHI3L1), C-X-C motif chemokine ligand 1 (CXCL1), matrix metallopeptidase 9 (MMP9), and granzyme B (GZMB), and confirmed them in clinical PBMC samples. Furthermore, the disease-gene-drug interaction network revealed the potential of key genes as reference markers in T1DM.
Conclusion
These results provide new insight into T1DM pathogenesis and novel biomarkers that could be widely representative reference indicators or potential therapeutic targets for clinical applications.

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Short Communication

Others
Comparison of Insulin-Treated Patients with Ambiguous Diabetes Type with Definite Type 1 and Type 2 Diabetes Mellitus Subjects: A Clinical Perspective: Insa Laspe, Juris J. Meier, Michael A. Nauck; Diabetes Metab J. 2023;47(1):140-146. Published online March 22, 2022; DOI: https://doi.org/10.4093/dmj.2021.0322

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In clinical practice, the distinction between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) can be challenging, leaving patients with “ambiguous” diabetes type. Insulin-treated patients (n=115) previously diagnosed with T2DM had to be re-classified based on clinical phenotype and laboratory results, and were operationally defined as having an ambiguous diabetes type. They were compared against patients with definite T1DM and T2DM regarding 12 clinical and laboratory features typically different between diabetes types. Characteristics of patients with ambiguous diabetes type, representing approximately 6% of all patients with T1DM or T2DM seen at our specialized clinic, fell in between those of patients with definite T1DM and T2DM, both regarding individual features and with respect to a novel classification based on multi-variable regression analysis (P<0.0001). In conclusion, a substantial proportion of diabetes patients in a tertiary care centre presented with an “ambiguous” diabetes type. Their clinical characteristics fall in between those of definite T1DM or T2DM patients.

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Original Article

Type 1 Diabetes
Abnormal Responses in Cognitive Impulsivity Circuits Are Associated with Glycosylated Hemoglobin Trajectories in Type 1 Diabetes Mellitus and Impaired Metabolic Control: Helena Jorge, Isabel C. Duarte, Sandra Paiva, Ana Paula Relvas, Miguel Castelo-Branco; Diabetes Metab J. 2022;46(6):866-878. Published online March 22, 2022; DOI: https://doi.org/10.4093/dmj.2021.0307

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Background
Risky health decisions and impulse control profiles may impact on metabolic control in type 1 diabetes mellitus (T1DM). We hypothesize that the neural correlates of cognitive impulsivity and decision-making in T1DM relate to metabolic control trajectories.
Methods
We combined functional magnetic resonance imaging (fMRI), measures of metabolic trajectories (glycosylated hemoglobin [HbA1c] over multiple time points) and behavioral assessment using a cognitive impulsivity paradigm, the Balloon Analogue Risk Task (BART), in 50 participants (25 T1DM and 25 controls).
Results
Behavioral results showed that T1DM participants followed a rigid conservative risk strategy along the iterative game. Imaging group comparisons showed that patients showed larger activation of reward related, limbic regions (nucleus accumbens, amygdala) and insula (interoceptive saliency network) in initial game stages. Upon game completion differences emerged in relation to error monitoring (anterior cingulate cortex [ACC]) and inhibitory control (inferior frontal gyrus). Importantly, activity in the saliency network (ACC and insula), which monitors interoceptive states, was related with metabolic trajectories, which was also found for limbic/reward networks. Parietal and posterior cingulate regions activated both in controls and patients with adaptive decision-making, and positively associated with metabolic trajectories.
Conclusion
We found triple converging evidence when comparing metabolic trajectories, patients versus controls or risk averse (non-learners) versus patients who learned by trial and error. Dopaminergic reward and saliency (interoceptive and error monitoring) circuits show a tight link with impaired metabolic trajectories and cognitive impulsivity in T1DM. Activity in parietal and posterior cingulate are associated with adaptive trajectories. This link between reward-saliency-inhibition circuits suggests novel strategies for patient management.

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Short Communications

Pathophysiology
Glutamic Acid Decarboxylase and Tyrosine Phosphatase-Related Islet Antigen-2 Positivity among Children and Adolescents with Diabetes in Korea: Ka Young Kim, Min Seung Kim, Yun Jeong Lee, Young Ah Lee, Seong Yong Lee, Choong Ho Shin, Jae Hyun Kim; Diabetes Metab J. 2022;46(6):948-952. Published online March 8, 2022; DOI: https://doi.org/10.4093/dmj.2021.0332

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Abstract PDF Supplementary Material PubReader ePub

Autoantibodies against glutamic acid decarboxylase (GADA), tyrosine phosphatase-related islet antigen 2 (IA2A), insulin (INSA), and islet cells (ICA) are critical for determining the type of diabetes and management strategy in new-onset diabetes mellitus (NODM), but there have been few reports of all diabetes-associated autoantibody (DAA) in Korea. We retrospectively analyzed 193 patients with NODM aged 0 to 18 years who were followed at two tertiary centers in Korea (2017 to 2021). Patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) were 93 (48.2%) and 100 (51.8%), respectively. In T1DM patients, the DAA positivity rate was 94.6%; prevalence of GADA, IA2A, INSA, and ICA was 71.0%, 71.0%, 31.2%, and 10.8%, respectively; and IA2A added 10.7% point autoantibody positivity (83.9% for GADA+INSA+ICA and 94.6% for GADA+INSA+ICA+IA2A). Among the patients with T2DM, 12 (12.0%) were positive for DAA, and all were positive for INSA. These findings suggest that DAA at diagnosis, especially GADA and IA2A, is useful for classifying diabetes in Korean children and adolescents.

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Prevalence, Diagnostic Role, and Clinical Features of Zinc Transporter 8 Autoantibody in Korean Children and Adolescents With Diabetes Mellitus
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Technology/Device
A 4-Week, Two-Center, Open-Label, Single-Arm Study to Evaluate the Safety and Efficacy of EOPatch in Well-Controlled Type 1 Diabetes Mellitus: Jiyun Park, Nammi Park, Sangjin Han, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Woo Je Lee, Jae Hyeon Kim; Diabetes Metab J. 2022;46(6):941-947. Published online March 8, 2022; DOI: https://doi.org/10.4093/dmj.2021.0299

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Abstract PDF Supplementary Material PubReader ePub

This study evaluated the safety and efficacy of tubeless patch pump called EOPatch in patients with well-controlled type 1 diabetes mellitus (T1DM). This 4-week, two-center, open-label, single-arm study enrolled 10 adult patients diagnosed with T1DM with glycosylated hemoglobin less than 7.5%. The co-primary end points were patch pump usage time for one attachment and number of serious adverse events related to the patch pump. The secondary end points were total amount of insulin injected per patch and changes in glycemic parameters including continuous glucose monitoring data compared to those at study entry. The median usage time per patch was 84.00 hours (interquartile range, 64.50 to 92.50). Serious adverse events did not occur during the trial. Four weeks later, time in range 70 to 180 mg/dL was significantly improved (70.71%±17.14 % vs. 82.96%±9.14%, P=0.01). The times spent below range (<54 mg/dL) and above range (>180 mg/dL) also improved (All P<0.05). Four-week treatment with a tubeless patch pump was safe and led to clinical improvement in glycemic control.

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Shweta Mishra, Ashlesha J. Chauhan, Jayaveersinh Mahida
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Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
Endocrinology and Metabolism.2025;[Epub] CrossRef
Multilayer track‐etched membrane‐based electroosmotic pump for drug delivery
Qian Yang, Zebo Zhang, Junshu Lin, Boyu Zhu, Rongying Yu, Xinru Li, Bin Su, Bo Zhao
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Comparison between a tubeless, on-body automated insulin delivery system and a tubeless, on-body sensor-augmented pump in type 1 diabetes: a multicentre randomised controlled trial
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Approaches of wearable and implantable biosensor towards of developing in precision medicine
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Mohammad Towhidul Islam Rimon, Md Wasif Hasan, Mohammad Fuad Hassan, Sevki Cesmeci
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A true continuous healthcare system for type 1 diabetes
Jiyong Kim, Salman Khan, Eun Kyu Kim, Hye-Jun Kil, Bo Min Kang, Hyo Geon Lee, Jin-Woo Park, Jun Young Yoon, Woochul Kim
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Brief Report

Technology/Device
Do-It-Yourself Open Artificial Pancreas System in Children and Adolescents with Type 1 Diabetes Mellitus: Real-World Data: Min Sun Choi, Seunghyun Lee, Jiwon Kim, Gyuri Kim, Sung Min Park, Jae Hyeon Kim; Diabetes Metab J. 2022;46(1):154-159. Published online November 23, 2021; DOI: https://doi.org/10.4093/dmj.2021.0011

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Abstract PDF Supplementary Material PubReader ePub

Few studies have been conducted among Asian children and adolescents with type 1 diabetes mellitus (T1DM) using do-it-yourself artificial pancreas system (DIY-APS). We evaluated real-world data of pediatric T1DM patients using DIY-APS. Data were obtained for 10 patients using a DIY-APS with algorithms. We collected sensor glucose and insulin delivery data from each participant for a period of 4 weeks. Average glycosylated hemoglobin was 6.2%±0.3%. The mean percentage of time that glucose level remained in the target range of 70 to 180 mg/dL was 82.4%±7.8%. Other parameters including time above range, time below range and mean glucose were also within the recommended level, similar to previous commercial and DIY-APS studies. However, despite meeting the target range, unadjusted gaps were still observed between the median basal setting and temporary basal insulin, which should be handled by healthcare providers.

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Efficacy and Safety of a Non-Carbohydrate Counting Meal Bolus Strategy in Adults with Type 1 Diabetes Using Open-Source Automated Insulin Delivery
Yunying Cai, Le Ma, Lun Zhang, Qiongli Neng, Heng Su
Diabetes Technology & Therapeutics.2025; 27(10): 831. CrossRef
Efficacy and safety of a tubeless open‐source hybrid automated insulin delivery use at home among adults with type 1 diabetes mellitus: Results from a 26‐week, free‐living, randomized crossover trial
Mengyun Lei, Ping Ling, Beisi Lin, Jing Lv, Zhigu Liu, Yongwen Zhou, Hongrong Deng, Daizhi Yang, Chaofan Wang, Xubin Yang, Jinhua Yan, Wen Xu
Diabetes, Obesity and Metabolism.2025; 27(9): 4699. CrossRef
Effective blood glucose control in Chinese children with type 1 diabetes via a do-it-yourself artificial pancreas system: a single-center study
Lihong Yang, Fei Xie, Linqi Han, Fengyan You, Zhiqiang Wei, Caihong Liu, Chao Xu, Yan Sun
Therapeutic Advances in Endocrinology and Metabolism.2025;[Epub] CrossRef
Factors of Composite Target of Time in Range and Time Below Range Among Children and Adolescents With Type 1 Diabetes Mellitus Using Open-Source Automated Insulin Delivery
Mengyun Lei, Yongwen Zhou, Chaofan Wang, Ping Ling, Ying Ni, Daizhi Yang, Xubin Yang, Wen Xu, Hongrong Deng, Jinhua Yan
Endocrine Practice.2025; 31(12): 1538. CrossRef
Real-world efficacy and safety of open-source automated insulin delivery for people with type 1 diabetes mellitus: Experience from mainland China
Yongwen Zhou, Mengyun Lei, Daizhi Yang, Ping Ling, Ying Ni, Hongrong Deng, Wen Xu, Xubin Yang, Benjamin John Wheeler, Jianping Weng, Jinhua Yan
Diabetes Research and Clinical Practice.2024; 218: 111910. CrossRef
Advances in Continuous Glucose Monitoring and Integrated Devices for Management of Diabetes with Insulin-Based Therapy: Improvement in Glycemic Control
Jee Hee Yoo, Jae Hyeon Kim
Diabetes & Metabolism Journal.2023; 47(1): 27. CrossRef
Open-source automated insulin delivery systems (OS-AIDs) in a pediatric population with type 1 diabetes in a real-life setting: the AWeSoMe study group experience
Judith Nir, Marianna Rachmiel, Abigail Fraser, Yael Lebenthal, Avivit Brener, Orit Pinhas-Hamiel, Alon Haim, Eve Stern, Noa Levek, Tal Ben-Ari, Zohar Landau
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Antonia Huhndt, Yanbing Chen, Shane O’Donnell, Drew Cooper, Hanne Ballhausen, Katarzyna A. Gajewska, Timothée Froment, Mandy Wäldchen, Dana M. Lewis, Klemens Raile, Timothy C. Skinner, Katarina Braune
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Review

Technology/Device
Current Advances of Artificial Pancreas Systems: A Comprehensive Review of the Clinical Evidence: Sun Joon Moon, Inha Jung, Cheol-Young Park; Diabetes Metab J. 2021;45(6):813-839. Published online November 22, 2021; DOI: https://doi.org/10.4093/dmj.2021.0177

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Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Since Banting and Best isolated insulin in the 1920s, dramatic progress has been made in the treatment of type 1 diabetes mellitus (T1DM). However, dose titration and timely injection to maintain optimal glycemic control are often challenging for T1DM patients and their families because they require frequent blood glucose checks. In recent years, technological advances in insulin pumps and continuous glucose monitoring systems have created paradigm shifts in T1DM care that are being extended to develop artificial pancreas systems (APSs). Numerous studies that demonstrate the superiority of glycemic control offered by APSs over those offered by conventional treatment are still being published, and rapid commercialization and use in actual practice have already begun. Given this rapid development, keeping up with the latest knowledge in an organized way is confusing for both patients and medical staff. Herein, we explore the history, clinical evidence, and current state of APSs, focusing on various development groups and the commercialization status. We also discuss APS development in groups outside the usual T1DM patients and the administration of adjunct agents, such as amylin analogues, in APSs.

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Multivariable Automated Insulin Delivery System for Handling Planned and Spontaneous Physical Activities
Mohammad Reza Askari, Mohammad Ahmadasas, Andrew Shahidehpour, Mudassir Rashid, Laurie Quinn, Minsun Park, Ali Cinar
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Advanced Technology (Continuous Glucose Monitoring and Advanced Hybrid Closed-Loop Systems) in Diabetes from the Perspective of Gender Differences
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Artificial Pancreas under a Zone Model Predictive Control based on Gaussian Process models: toward the personalization of the closed loop
Marco Polver, Beatrice Sonzogni, Mirko Mazzoleni, Fabio Previdi, Antonio Ferramosca
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Original Article

Type 1 Diabetes
Association between Metabolic Syndrome and Microvascular Complications in Chinese Adults with Type 1 Diabetes Mellitus: Qianwen Huang, Daizhi Yang, Hongrong Deng, Hua Liang, Xueying Zheng, Jinhua Yan, Wen Xu, Xiangwen Liu, Bin Yao, Sihui Luo, Jianping Weng; Diabetes Metab J. 2022;46(1):93-103. Published online August 31, 2021; DOI: https://doi.org/10.4093/dmj.2020.0240

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Background
Both type 1 diabetes mellitus (T1DM) and metabolic syndrome (MetS) are associated with an elevated risk of morbidity and mortality yet with increasing heterogeneity. This study primarily aimed to evaluate the prevalence of MetS among adult patients with T1DM in China and investigate its associated risk factors, and relationship with microvascular complications.
Methods
We included adult patients who had been enrolled in the Guangdong T1DM Translational Medicine Study conducted from June 2010 to June 2015. MetS was defined according to the updated National Cholesterol Education Program criterion. Logistic regression models were used to estimate the odds ratio (OR) for the association between MetS and the risk of diabetic kidney disease (DKD) and diabetic retinopathy (DR).
Results
Among the 569 eligible patients enrolled, the prevalence of MetS was 15.1%. While female gender, longer diabetes duration, higher body mass index, and glycosylated hemoglobin A1c (HbA1c) were risk factors associated with MetS (OR, 2.86, 1.04, 1.14, and 1.23, respectively), received nutrition therapy education was a protective factor (OR, 0.46). After adjustment for gender, age, diabetes duration, HbA1c, socioeconomic and lifestyle variables, MetS status was associated with an increased risk of DKD and DR (OR, 2.14 and 3.72, respectively; both P<0.05).
Conclusion
Although the prevalence of MetS in adult patients with T1DM in China was relatively low, patients with MetS were more likely to have DKD and DR. A comprehensive management including lifestyle modification might reduce their risk of microvascular complications in adults with T1DM.

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Kamila Pieńczykowska, Anna Bryl, Małgorzata Mrugacz
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Metabolic syndrome in type 1 diabetes: higher time above range and glycemic variability revealed by continuous glucose monitoring (CGM)
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Current status, trend changes, and future predictions of the disease burden of type 1 diabetes kidney disease in global and China
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Metabolic syndrome in type 1 diabetes mellitus in adults
R. I. Malievskaya, D. S. Avzaletdinova, I. G. Nasretdinova, I. Z. Urmanova, D. F. Iksanova
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Association between metabolic phenotype and diabetic kidney disease in adult-onset type 1 diabetes patients from China: A multi-center cross-sectional study
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Gyuri Kim
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Short Communication

Type 1 Diabetes
Real-World Analysis of Therapeutic Outcome in Type 1 Diabetes Mellitus at a Tertiary Care Center: Antonia Kietaibl, Michaela Riedl, Latife Bozkurt; Diabetes Metab J. 2022;46(1):149-153. Published online July 6, 2021; DOI: https://doi.org/10.4093/dmj.2020.0267

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Insulin replacement in type 1 diabetes mellitus (T1DM) needs intensified treatment, which can either be performed by multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). This retrospective analysis of a real-world scenario aimed to evaluate whether glycaemic and cardiovascular risk factors could be controlled with CSII outclass MDI as suggested by recent evidence. Data from patients with either insulin pump (n=68) or injection (n=224) therapy at an Austrian tertiary care centre were analysed between January 2016 and December 2017. There were no significant differences with regard to the latest glycosylated hemoglobin, cardiovascular risk factor control or diabetes-associated late complications. Hypoglycaemia was less frequent (P<0.001), sensor-augmented therapy was more common (P=0.003) and mean body mass index (BMI) was higher (P=0.002) with CSII treatment. This retrospective analysis of real-world data in T1DM did not demonstrate the superiority of insulin pump treatment with regard to glycaemic control or cardiovascular risk factor control.

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Islet Tissue Macrophages in Immunity Homeostasis and Type 1 Diabetes
Yan Wang, Zhaoran Wang, Wenya Diao, Tong Shi, Jiahe Xu, Tiantian Deng, Chaoying Wen, Jienan Gu, Tingting Deng, Sixuan Wang, Cheng Xiao
Clinical Reviews in Allergy & Immunology.2025;[Epub] CrossRef

Original Article

Genetics
The rs2304256 Polymorphism in TYK2 Gene Is Associated with Protection for Type 1 Diabetes Mellitus: Felipe Mateus Pellenz, Cristine Dieter, Guilherme Coutinho Kullmann Duarte, Luís Henrique Canani, Bianca Marmontel de Souza, Daisy Crispim; Diabetes Metab J. 2021;45(6):899-908. Published online May 24, 2021; DOI: https://doi.org/10.4093/dmj.2020.0194

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Background
Tyrosine kinase 2 (TYK2) is a candidate gene for type 1 diabetes mellitus (T1DM) since it plays an important role in regulating apoptotic and pro-inflammatory pathways in pancreatic β-cells through modulation of the type I interferon signaling pathway. The rs2304256 single nucleotide polymorphism (SNP) in TYK2 gene has been associated with protection for different autoimmune diseases. However, to date, only two studies have evaluated the association between this SNP and T1DM, with discordant results. This study thus aimed to investigate the association between the TYK2 rs2304256 SNP and T1DM in a Southern Brazilian population.
Methods
This case-control study comprised 478 patients with T1DM and 518 non-diabetic subjects. The rs2304256 (C/A) SNP was genotyped by real-time polymerase chain reaction technique using TaqMan minor groove binder (MGB) probes.
Results
Genotype and allele frequencies of the rs2304256 SNP differed between T1DM patients and non-diabetic subjects (P<0.0001 and P=0.001, respectively). Furthermore, the A allele was associated with protection against T1DM under recessive (odds ratio [OR], 0.482; 95% confidence interval [CI], 0.288 to 0.806) and additive (OR, 0.470; 95% CI, 0.278 to 0.794) inheritance models, adjusting for human leukocyte antigen (HLA) DR/DQ genotypes, gender, and ethnicity.
Conclusion
The A/A genotype of TYK2 rs2304256 SNP is associated with protection against T1DM in a Southern Brazilian population.

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Kateryna Kozak, Halyna Pavlyshyn, Oleksandr Kamyshnyi, Oksana Shevchuk, Mykhaylo Korda, Sandor G. Vari
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Pharmacological inhibition of tyrosine protein-kinase 2 reduces islet inflammation and delays type 1 diabetes onset in mice
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Review

Type 1 Diabetes
Non-Insulin Antidiabetes Treatment in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis: Xiaoling Cai, Chu Lin, Wenjia Yang, Lin Nie, Linong Ji; Diabetes Metab J. 2021;45(3):312-325. Published online March 15, 2021; DOI: https://doi.org/10.4093/dmj.2020.0171

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In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.

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A Retrospective Analysis of the Clinical Characteristics and Treatment Patterns Among Individuals with Diabetes Receiving Insulin Therapy in Japan: The Insulin JP2DB Study
Michiaki Fukui, Satoshi Tsuboi, Yuiko Yamamoto, Yasuo Terauchi
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Glycemic Management Across the Lifespan for People With Type 1 Diabetes: A Clinical Practice Guideline
Ilana J. Halperin, Brandy Wicklow, Shazhan Amed, Alanna Chambers, Charlotte Courage, Elizabeth Cummings, Patricia Kirkland, Dylan MacKay, Meranda Nakhla, Zubin Punthakee, Paul M. Ryan, Lindsay Sawatsky, Peter A. Senior, Bikrampal S. Sidhu, Alanna Weisman
Canadian Journal of Diabetes.2025; 49(1): 5. CrossRef
Comparative efficacy and safety of oral hypoglycaemic drugs as adjunctive therapy in the management of type 1 diabetes mellitus: A systematic review and meta‐analysis
Dong Wu, Xiaowu Wang, Qiao Liu, Xia Luo
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Prescribing patterns of adjunctive therapy for the treatment of type 1 diabetes mellitus among Australian endocrinologists
Patrice Forner, Jennifer Snaith, Jerry R. Greenfield
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Dioscin: Therapeutic potential for diabetes and complications
Haoyang Gao, Ze Wang, Danlin Zhu, Linlin Zhao, Weihua Xiao
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The Impact of Body Mass Index, Residual Beta Cell Function and Estimated Glucose Disposal Rate on the Development of Double Diabetes and Microvascular Complications in Patients With Type 1 Diabetes Mellitus
Rameez Raja Bhagadurshah, Subbiah Eagappan, Raghavan Kasthuri Santharam, Sridhar Subbiah
Cureus.2023;[Epub] CrossRef
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Bruce A. Perkins, Jennifer L. Sherr, Chantal Mathieu
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Current Advances of Artificial Pancreas Systems: A Comprehensive Review of the Clinical Evidence
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Original Articles

Complications
Association of Urinary N-Acetyl-β-D-Glucosaminidase with Cardiovascular Autonomic Neuropathy in Type 1 Diabetes Mellitus without Nephropathy: Min Sun Choi, Ji Eun Jun, Sung Woon Park, Jee Hee Yoo, Jiyeon Ahn, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Moon-Kyu Lee, Jae Hyeon Kim; Diabetes Metab J. 2021;45(3):349-357. Published online February 2, 2021; DOI: https://doi.org/10.4093/dmj.2019.0211

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Background
Cardiovascular autonomic neuropathy (CAN) is a common microvascular complication of diabetes and related to albuminuria in diabetic nephropathy (DN). Urinary N-acetyl-β-D-glucosaminidase (uNAG) is a renal tubular injury marker which has been reported as an early marker of DN even in patients with normoalbuminuria. This study evaluated whether uNAG is associated with the presence and severity of CAN in patients with type 1 diabetes mellitus (T1DM) without nephropathy.
Methods
This cross-sectional study comprised 247 subjects with T1DM without chronic kidney disease and albuminuria who had results for both uNAG and autonomic function tests within 3 months. The presence of CAN was assessed by age-dependent reference values for four autonomic function tests. Total CAN score was assessed as the sum of the partial points of five cardiovascular reflex tests and was used to estimatethe severity of CAN. The correlations between uNAG and heart rate variability (HRV) parameters were analyzed.
Results
The association between log-uNAG and presence of CAN was significant in a multivariate logistic regression model (adjusted odds ratio, 2.39; 95% confidence interval [CI], 1.08 to 5.28; P=0.031). Total CAN score was positively associated with loguNAG (β=0.261, P=0.026) in the multivariate linear regression model. Log-uNAG was inversely correlated with frequency-domain and time-domain indices of HRV.
Conclusion
This study verified the association of uNAG with presence and severity of CAN and changes in HRV in T1DM patients without nephropathy. The potential role of uNAG should be further assessed for high-risk patients for CAN in T1DM patients without nephropathy.

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Determination of Diabetes-associated Cardiovascular Autonomic Neuropathy Risk Factors among Insulin and Non-insulin Dependent Diabetics
Ibrahim Abdulsada, Zain Alabdeen Obaid, Farah Almerza, Mays Alwaeli, Anmar Al-Elayawi, Taha Al-Dayyeni, Harir Al-Tuhafy
The Journal of Medical Research.2023; 9(6): 141. CrossRef
Association between carotid atherosclerosis and presence of intracranial atherosclerosis using three-dimensional high-resolution vessel wall magnetic resonance imaging in asymptomatic patients with type 2 diabetes
Ji Eun Jun, You-Cheol Hwang, Kyu Jeong Ahn, Ho Yeon Chung, Geon-Ho Jahng, Soonchan Park, In-Kyung Jeong, Chang-Woo Ryu
Diabetes Research and Clinical Practice.2022; 191: 110067. CrossRef

Type 1 Diabetes
Incidence and Prevalence of Type 1 Diabetes Mellitus among Korean Children and Adolescents between 2007 and 2017: An Epidemiologic Study Based on a National Database: Hyun Wook Chae, Gi Hyeon Seo, Kyungchul Song, Han Saem Choi, Junghwan Suh, Ahreum Kwon, Sangmi Ha, Ho-Seong Kim; Diabetes Metab J. 2020;44(6):866-874. Published online November 4, 2020; DOI: https://doi.org/10.4093/dmj.2020.0212

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Background
The incidence of type 1 diabetes mellitus (T1DM) among children is high in Europe and the USA and relatively low in Asia, including Korea. The present study aimed to investigate the incidence and prevalence of childhood-onset T1DM in Korea and examine trends in incidence.
Methods
This study was conducted using the national registry data provided by the Health Insurance Review and Assessment Service in Korea from 2007 to 2017. We included children aged 0 to 14 years who were newly registered with a T1DM diagnosis each year (code E10).
Results
A total of 29,013 children were registered. The overall incidence of T1DM was 4.45 per 100,000 persons (girls, 4.93; boys, 4.01). The overall incidence of childhood-onset T1DM in Korea increased from 3.70 in 2008 to 4.77 in 2016 (P=0.002). The incidence of T1DM increased from 3.07 in 2008 to 4.89 in 2016 (P<0.001) among boys. Although the incidence of the disease increased significantly among boys aged 5–9 and 10–14 years, it remained constant among girls (4.39 in 2008, 4.64 in 2016). The overall prevalence of childhood-onset T1DM in Korea increased from 32.85 in 2007 to 41.03 per 100,000 persons in 2017 (girls, 35.54 to 43.88; boys, 32.85 to 41.03).
Conclusion
We calculated relatively accurate incidence and prevalence of childhood-onset T1DM from a nation-based registry. The incidence increased by 3% to 4% every year from 2007 to 2017. The increasing trend is noteworthy compared with previous reports.

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Type 1 Diabetes
Differential Profile of Plasma Circular RNAs in Type 1 Diabetes Mellitus: Yangyang Li, Ying Zhou, Minghui Zhao, Jing Zou, Yuxiao Zhu, Xuewen Yuan, Qianqi Liu, Hanqing Cai, Cong-Qiu Chu, Yu Liu; Diabetes Metab J. 2020;44(6):854-865. Published online July 13, 2020; DOI: https://doi.org/10.4093/dmj.2019.0151

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Background

No currently available biomarkers or treatment regimens fully meet therapeutic needs of type 1 diabetes mellitus (T1DM). Circular RNA (circRNA) is a recently identified class of stable noncoding RNA that have been documented as potential biomarkers for various diseases. Our objective was to identify and analyze plasma circRNAs altered in T1DM.

Methods

We used microarray to screen differentially expressed plasma circRNAs in patients with new onset T1DM (n=3) and age-/gender-matched healthy controls (n=3). Then, we selected six candidates with highest fold-change and validated them by quantitative real-time polymerase chain reaction in independent human cohort samples (n=12). Bioinformatic tools were adopted to predict putative microRNAs (miRNAs) sponged by these validated circRNAs and their downstream messenger RNAs (mRNAs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed to gain further insights into T1DM pathogenesis.

Results

We identified 68 differentially expressed circRNAs, with 61 and seven being up- and downregulated respectively. Four of the six selected candidates were successfully validated. Curations of their predicted interacting miRNAs revealed critical roles in inflammation and pathogenesis of autoimmune disorders. Functional relations were visualized by a circRNA-miRNA-mRNA network. GO and KEGG analyses identified multiple inflammation-related processes that could be potentially associated with T1DM pathogenesis, including cytokine-cytokine receptor interaction, inflammatory mediator regulation of transient receptor potential channels and leukocyte activation involved in immune response.

Conclusion

Our study report, for the first time, a profile of differentially expressed plasma circRNAs in new onset T1DM. Further in silico annotations and bioinformatics analyses supported future application of circRNAs as novel biomarkers of T1DM.

Citations

Citations to this article as recorded by

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Type 1 Diabetes
Age at Diagnosis and the Risk of Diabetic Nephropathy in Young Patients with Type 1 Diabetes Mellitus: Jong Ha Baek, Woo Je Lee, Byung-Wan Lee, Soo Kyoung Kim, Gyuri Kim, Sang-Man Jin, Jae Hyeon Kim; Diabetes Metab J. 2021;45(1):46-54. Published online July 10, 2020; DOI: https://doi.org/10.4093/dmj.2019.0134

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Background

The aim of this study was to evaluate characteristics and risk of diabetic complications according to age at diagnosis among young adults with type 1 diabetes mellitus (T1DM).

Methods

A total of 255 T1DM patients aged less than 40 years were included. Patients were categorized into three groups (<20, 20 to 29, and 30 to 40 years) according to age at diagnosis. Diabetic nephropathy (DN) was defined when spot urine-albumin creatinine ratio was 300 mg/g or more and/or estimated glomerular filtration ratio (eGFR) level was 60 mL/min/1.73 m² or less.

Results

Median age at diagnosis was 25 years and disease duration was 14 years. Individuals diagnosed with T1DM at childhood/adolescent (age <20 years) had lower stimulated C-peptide levels. They received more intensive insulin treatment with higher total daily insulin doses compared to older onset groups. The prevalence of DN was higher in the childhood/adolescent-onset group than in older onset groups (25.3% vs. 15.3% vs. 9.6%, P=0.022). The eGFR was inversely associated with disease duration whilst the degree of decrease was more prominent in the childhood/adolescent-onset group than in the later onset group (aged 30 to 40 years; P<0.001). Childhood/adolescent-onset group was independently associated with the risk of DN compared to the older onset group (aged 30 to 40 years; odds ratio, 3.47; 95% confidence interval, 1.45 to 8.33; P=0.005).

Conclusion

In individuals with childhood/adolescent-onset T1DM, the reduction in renal function is more prominent with disease duration. Early age-onset T1DM is an independent risk of DN.

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Diabetes & Metabolism Journal.2021; 45(2): 277. CrossRef
Role of magnetic resonance diffusion weighted imaging in diagnosis of diabetic nephropathy in children living with type 1 diabetes mellitus
Eman Nabil Wahba, Ashraf Elsharkawy, Mohammad Hosny Awad, Ashraf Abdel Rahman, Amr Sarhan
Journal of Pediatric Endocrinology and Metabolism.2021; 34(12): 1585. CrossRef

Lifestyle
Persistent Anxiety Is Associated with Higher Glycemia Post-Transition to Adult Services in Asian Young Adults with Diabetes: Ling Zhu, Suresh Rama Chandran, Wee Boon Tan, Xiaohui Xin, Su-Yen Goh, Daphne Su-Lyn Gardner; Diabetes Metab J. 2021;45(1):67-76. Published online June 15, 2020; DOI: https://doi.org/10.4093/dmj.2019.0226

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Background

There is little longitudinal information on psychological burden and metabolic outcomes in young adults with diabetes (YAD) in Asia. We aimed to evaluate the association between psychological status and glycemia at baseline and 2 years following transition in a cohort of YAD in Singapore.

Methods

Subjects with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), aged 17 to 25 years, were recruited from the YAD clinic in Singapore General Hospital. The Hospital Anxiety and Depression and Problem Areas for Diabetes scales were administered at transition (baseline) and at 18 to 24 months. Glycosylated hemoglobin (HbA1c) assessed during routine visits was tracked longitudinally.

Results

A total of 98 T1DM (74.8%) and 33 T2DM (25.2%) subjects were recruited between January 2011 and November 2017. At baseline, mean HbA1c was 8.6%±1.7%. Only 26.0% achieved HbA1c of ≤7.5% and 16.8% achieved HbA1c of <7%. At baseline, prevalence of anxiety was 29.8%. At 24 months, 14.1% had persistent anxiety. Those with persistent anxiety had the highest mean HbA1c, particularly at 6 months (persistently anxious vs. persistently non-anxious: 9.9%±1.2% vs. 8.2%±1.9%, P=0.009). At baseline, 9.2% of subjects had depression. This group also had poorer glycemia at baseline (HbA1c of depressed vs non-depressed: 9.6%±2.1% vs. 8.5%±1.6%, P=0.04), which persisted up to 24 months.

Conclusion

The majority of YAD in Singapore have suboptimal glycemia. Psychological distress is a critical harbinger of poorer metabolic outcomes.

Citations

Citations to this article as recorded by

Beyond Glycaemia
Suresh Rama Chandran, Gilbert Soh Keng Keat, Nur Nasyitah Binte Mohamed Salim, Xiaohui Xin, Gek Hsiang Lim, Daphne Gardner, Su-Yen Goh
Journal of the ASEAN Federation of Endocrine Societies.2025;[Epub] CrossRef
Navigating Transition to Adult Care in Youth-Onset Type 2 Diabetes: Facilitators, Attitudes, Barriers, and Behaviors
Sophia Beth Glaros, Sydney Annemarie Dixon, Noemi Malandrino, Faith Suzanne Davis, Aruba Chowdhury, Ila Nikki Kacker, Natalie Ann Macheret, Samson Levy Cantor, Geethika Thota, Lilian Mabundo, Catherine Mason Gordon, Marissa Lightbourne, Doris Elizabeth Es
The Journal of Clinical Endocrinology & Metabolism.2025; 110(12): 3412. CrossRef
Transitioning to adult care in youth-onset diabetes: a scoping review of socio-ecological factors in youth-onset type 2 diabetes compared to type 1 diabetes
Assumpta O. Ude, Sydney A. Dixon, Sophia B. Glaros, Sue-Ann Arboine, Nancy L. Terry, Tomás Cabeza De Baca, Stephanie T. Chung
BMC Public Health.2025;[Epub] CrossRef
The relationship between depression, anxiety and health literacy with the severity of diabetes: the mediating role of fear of disease progression
Fatemeh Fallah, Mohammad Kazem Atef Vahid, Mahdieh Salehi
Journal of Diabetes & Metabolic Disorders.2025;[Epub] CrossRef
Transdisciplinary care intervention for young adults with type 1 diabetes transitioning to adult healthcare: Rationale and trial design
Jessica S. Pierce, Nicole Morales, Melissa A. Alderfer, Kamyar Arasteh, Shilpa Gurnurkar
Contemporary Clinical Trials.2025; 157: 108073. CrossRef
A Systematic Review of Factors Associated With Transition Readiness and the Transfer to Adult Health Care for Young People With Diabetes
Jaclyn L. Papadakis, Sean DeLacey, Frank J. Snoek, Steven James, Eva Toft, Laura Cudizio, Aleksandra Araszkiewicz, Carine de Beaufort, Apoorva Gomber, Sarah K. Lyons, Nisa M. Maruthur, Sze May Ng, Jill Weissberg-Benchell
Clinical Diabetes.2025; 43(5): 703. CrossRef
The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System Compared to Standard Management of Type 1 Diabetes in a Singapore Setting
Daphne Gardner, Mrinmayee Lakkad, Zhiyu Qiu, Yuta Inoue, Suresh Rama Chandran, Kael Wherry
Diabetes Technology & Therapeutics.2024; 26(5): 324. CrossRef
Impact of diabetes distress on glycemic control and diabetic complications in type 2 diabetes mellitus
Hye-Sun Park, Yongin Cho, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, Young Ju Suh, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Kwan Woo Lee, So Hun Kim
Scientific Reports.2024;[Epub] CrossRef
The Interaction of Glycemia with Anxiety and Depression Is Related to Altered Cerebellar and Cerebral Functional Correlations
Grace E. Shearrer
Brain Sciences.2023; 13(7): 1086. CrossRef
The prevalence of anxiety in adult endocrinology outpatients: A systematic review and meta–analysis
Kelly Ann Kershaw, Ben Storer, Taylor Braund, Cassandra Chakouch, Matthew Coleshill, Sam Haffar, Samuel Harvey, Jill Newby, Gemma Sicouri, Michael Murphy
Psychoneuroendocrinology.2023; 158: 106357. CrossRef
Increased Levels of Serum Glycosylated Hemoglobin are Associated with Depressive Symptoms in a Population with Cancer (≥49 Years): An Antidepressant-Stratified Analysis
Ying Huang, Yilin Xu, Anwen Liu
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The Burden of Type 2 Diabetes and the Value of Achieving Near Normoglycemia from the Patient Perspective
Heather Gelhorn, Zaneta Balantac, Shraddha Shinde, Vivian Thuyanh Thieu, Kristina S. Boye
Diabetes Therapy.2021; 12(7): 1821. CrossRef

Complications
Therapeutic Effects of Fibroblast Growth Factor-21 on Diabetic Nephropathy and the Possible Mechanism in Type 1 Diabetes Mellitus Mice: Wenya Weng, Tingwen Ge, Yi Wang, Lulu He, Tinghao Liu, Wanning Wang, Zongyu Zheng, Lechu Yu, Chi Zhang, Xuemian Lu; Diabetes Metab J. 2020;44(4):566-580. Published online May 15, 2020; DOI: https://doi.org/10.4093/dmj.2019.0089

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Background

Fibroblast growth factor 21 (FGF21) has been only reported to prevent type 1 diabetic nephropathy (DN) in the streptozotocin-induced type 1 diabetes mellitus (T1DM) mouse model. However, the FVB (Cg)-Tg (Cryaa-Tag, Ins2-CALM1) 26OVE/PneJ (OVE26) transgenic mouse is a widely recommended mouse model to recapture the most important features of T1DM nephropathy that often occurs in diabetic patients. In addition, most previous studies focused on exploring the preventive effect of FGF21 on the development of DN. However, in clinic, development of therapeutic strategy has much more realistic value compared with preventive strategy since the onset time of DN is difficult to be accurately predicted. Therefore, in the present study OVE26 mice were used to investigate the potential therapeutic effects of FGF21 on DN.

Methods

Four-month-old female OVE26 mice were intraperitoneally treated with recombinant FGF21 at a dose of 100 µg/kg/day for 3 months. The diabetic and non-diabetic control mice were treated with phosphate-buffered saline at the same volume. Renal functions, pathological changes, inflammation, apoptosis, oxidative stress and fibrosis were examined in mice of all groups.

Results

The results showed that severe renal dysfunction, morphological changes, inflammation, apoptosis, and fibrosis were observed in OVE26 mice. However, all the renal abnormalities above in OVE26 mice were significantly attenuated by 3-month FGF21 treatment associated with improvement of renal adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK) activity and sirtuin 1 (SIRT1) expression.

Conclusion

Therefore, this study demonstrated that FGF21 might exert therapeutic effects on DN through AMPK-SIRT1 pathway.

Citations

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Yudie Zhang, Fan Wang, Chongyang Zhang, Fan Yao, Bin Zhang, Yongping Zhang, Xiaobo Sun
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Erik J. Tillman, Tim Rolph
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Review

Clinical Diabetes & Therapeutics
Latent Autoimmune Diabetes in Adults: A Review on Clinical Implications and Management: Silvia Pieralice, Paolo Pozzilli; Diabetes Metab J. 2018;42(6):451-464. Published online December 17, 2018; DOI: https://doi.org/10.4093/dmj.2018.0190

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Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of β-cells loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down β-cell failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

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Original Articles

Epidemiology
High Proportion of Adult Cases and Prevalence of Metabolic Syndrome in Type 1 Diabetes Mellitus Population in Korea: A Nationwide Study: You-Bin Lee, Kyungdo Han, Bongsung Kim, Sang-Man Jin, Seung-Eun Lee, Ji Eun Jun, Jiyeon Ahn, Gyuri Kim, Jae Hyeon Kim; Diabetes Metab J. 2019;43(1):76-89. Published online August 22, 2018; DOI: https://doi.org/10.4093/dmj.2018.0048

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Background

The prevalence and incidence of type 1 diabetes mellitus (T1DM) in all age groups and the prevalence of metabolic syndrome in patients with T1DM in Korea were estimated.

Methods

The incidence and prevalence of T1DM between 2007 and 2013 were calculated using the Korean National Health Insurance Service (NHIS) datasets of claims. Clinical characteristics and prevalence of metabolic syndrome in individuals with T1DM between 2009 and 2013 were determined using the database of NHIS preventive health checkups.

Results

The prevalence of T1DM in Korea between 2007 and 2013 was 0.041% to 0.047%. The annual incidence rate of T1DM in Korea in 2007 to 2013 was 2.73 to 5.02/100,000 people. Although the incidence rate of typical T1DM was highest in teenagers, it remained steady in adults over 30 years of age. In contrast, the incidence rate of atypical T1DM in 2013 was higher in people aged 40 years or older than in younger age groups. Age- and sex-adjusted prevalence of metabolic syndrome in patients with T1DM was 51.65% to 55.06% between 2009 and 2013.

Conclusion

T1DM may be more common in Korean adults than previously believed. Metabolic syndrome may be a frequent finding in individuals with T1DM in Korea.

Citations

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Clinical Care/Education
Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes: Eun Young Joo, Ji-Eun Lee, Hee Sook Kang, Shin Goo Park, Yong Hee Hong, Young-Lim Shin, Min Sohn; Diabetes Metab J. 2018;42(6):480-487. Published online June 29, 2018; DOI: https://doi.org/10.4093/dmj.2018.0018

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Background

This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control.

Methods

Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires.

Results

Average total daily SMBG frequency was 3.8±2.1 and frequency during the school day was 1.3±1.2. The mean HbA1c level was 8.6%±1.4%. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ≥5 significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039).

Conclusion

Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

Citations

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Short Communication

Islet Studies and Transplantation
Alginate-Catechol Cross-Linking Interferes with Insulin Secretion Capacity in Isolated Murine Islet Cells: Yu-Sik Kim, Seung-Woo Cho, Bomin Ko, Jisoo Shin, Chul Woo Ahn; Diabetes Metab J. 2018;42(2):164-168. Published online March 28, 2018; DOI: https://doi.org/10.4093/dmj.2018.42.2.164

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Over the past three decades, human pancreatic islet isolation and transplantation techniques have developed as a routine clinical procedure for selected patients with type 1 diabetes mellitus. However, due to the donor shortage and required chronic systemic immunosuppression, the widespread application of islet transplantation is limited. To overcome these limitations, providing a physical barrier to transplanted islet cells with encapsulating biomaterial has emerged as a promising approach to enhance engraftment and promote islet survival post-transplantation. Alginate has been considered to be a reliable biomaterial, as it enhances islet survival and does not hamper hormone secretion. Alginate-catechol (Al-CA) hydrogel was reported to provide high mechanical strength and chemical stability without deformation over a wide range of pH values. In this study, we, demonstrated, for the first time in the literature, that encapsulation of murine pancreatic islet cells with Al-CA hydrogel does not induce cytotoxicity ex vivo for an extended period; however, it does markedly abate glucose-stimulated insulin secretion. Catechol should not be considered as a constituent for alginate gelation for encapsulating islet cells in the application of islet transplantation.

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Review

Clinical Diabetes & Therapeutics
Recent Updates on Type 1 Diabetes Mellitus Management for Clinicians: Ahmed Iqbal, Peter Novodvorsky, Simon R. Heller; Diabetes Metab J. 2018;42(1):3-18. Published online February 23, 2018; DOI: https://doi.org/10.4093/dmj.2018.42.1.3

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Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition that requires life-long administration of insulin. Optimal management of T1DM entails a good knowledge and understanding of this condition both by the physician and the patient. Recent introduction of novel insulin preparations, technological advances in insulin delivery and glucose monitoring, such as continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring and improved understanding of the detrimental effects of hypoglycaemia and hyperglycaemia offer new opportunities and perspectives in T1DM management. Evidence from clinical trials suggests an important role of structured patient education. Our efforts should be aimed at improved metabolic control with concomitant reduction of hypoglycaemia. Despite recent advances, these goals are not easy to achieve and can put significant pressure on people with T1DM. The approach of physicians should therefore be maximally supportive. In this review, we provide an overview of the recent advances in T1DM management focusing on novel insulin preparations, ways of insulin administration and glucose monitoring and the role of metformin or sodium-glucose co-transporter 2 inhibitors in T1DM management. We then discuss our current understanding of the effects of hypoglycaemia on human body and strategies aimed at mitigating the risks associated with hypoglycaemia.

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Original Articles

Clinical Care/Education
Depressive Symptoms Are Negatively Associated with Glucose Testing and Eating Meals on Time among Individuals with Diabetes in Zambia: Given Hapunda, Amina Abubakar, Frans Pouwer, Fons van de Vijver; Diabetes Metab J. 2017;41(6):440-448. Published online November 17, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.6.440

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Background

Depression is an established risk factor for cardiovascular diseases and mortality among individuals living with diabetes, and impaired self-care behaviors may play a mediating role. In Africa, this association is not very well known. In this study, we examined the associations between depressive symptoms and different aspects of diabetes self-care in Zambian individuals with diabetes mellitus.

Methods

A total of 157 individuals with diabetes mellitus participated. The sample was drawn from four city hospitals in Zambia. Diabetes self-care was assessed using the diabetes self-care inventory, and depression was assessed using the major depression inventory.

Results

Fifty-nine percent of the sample had type 1 diabetes mellitus. Variations in self-care activities and behaviors were reported as least adhered to by individuals with type 1 and type 2 diabetes mellitus, in adolescent and adult patients. Regression analysis indicated that there was no association between total diabetes self-care and the depression total score. However, depression was associated with poor glucose testing and not eating meals on time by patients with diabetes.

Conclusion

Some variance on poor self-care was explained by demographic characteristics, specifically age, body mass index, and to some extent, socioeconomic status. Recognition and successful treatment of depression in patients with diabetes might help to optimize self-care behaviors, especially glucose testing and eating meals on time. However, this hypothesis needs further testing.

Citations

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Psychosocial burden of diabetes in Africa: A systematic review and meta-analysis
Michelle Danny Stampley Boakye, Eric Peprah Osei, Samuel Akyirem, Shadrach Dare, Shammah Oluwabori Omololu, Emmanuel Ekpor, Irene Fosuhemaa Bossman, Dorothy Addo-Mensah, Precious Adade Duodu, Joseph Ngmenesegre Suglo
Journal of Health Psychology.2026; 31(3): 948. CrossRef
Anxiety and Depression Among Patients with Diabetes in Saudi Arabia and Egypt
Madiha Rabie Mahmoud, Ahmed Aljadani, Ammar A. Razzak Mahmood, Reem Falah Alshammari, Mona M. Shahien, Somia Ibrahim, Ashraf Abdel Khalik, Fahaad S. Alenazi, Fayez Alreshidi, Fatma Mohammad Nasr, Hend Faleh Alreshidi, Amal Daher Alshammari, Marwa H. Abdal
Healthcare.2024; 12(21): 2159. CrossRef
Self-management practices for preventing complications of type II diabetes mellitus in low and middle-income countries: A scoping review
Pauline Muthoni Maina, Melanie Pienaar, Marianne Reid
International Journal of Nursing Studies Advances.2023; 5: 100136. CrossRef
Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review
Sarah Masyuko, Carrie J. Ngongo, Carole Smith, Rachel Nugent, Cesario Bianchi
PLOS ONE.2021; 16(1): e0245269. CrossRef
Peripheral and Central Metabolites Affecting Depression, Anxiety, Suicidal Ideation, and Anger in Complex Regional Pain Syndrome Patients Using a Magnetic Resonance Spectroscopy: A Pilot Study
Ye-Ha Jung, Hyeonjin Kim, So Yeon Jeon, Jeong Min Kwon, Won Joon Lee, Joon Hwan Jang, Dasom Lee, Yoonji Lee, Do-Hyung Kang
Psychiatry Investigation.2018; 15(9): 891. CrossRef

Clinical Care/Education
The Role of Negative Affect in the Assessment of Quality of Life among Women with Type 1 Diabetes Mellitus: Nicola R. Gawlik, Malcolm J. Bond; Diabetes Metab J. 2018;42(2):130-136. Published online November 7, 2017; DOI: https://doi.org/10.4093/dmj.2018.42.2.130

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Background

The purpose of this study is to determine the impact of negative affect (defined in terms of lack of optimism, depressogenic attributional style, and hopelessness depression) on the quality of life of women with type 1 diabetes mellitus.

Methods

Participants (n=177) completed either an online or paper questionnaire made available to members of Australian diabetes support groups. Measures of optimism, attributional style, hopelessness depression, disease-specific data, and diabetes-related quality of life were sought. Bivariate correlations informed the construction of a structural equation model.

Results

Participants were 36.3±11.3 years old, with a disease duration of 18.4±11.2 years. Age and recent glycosylated hemoglobin readings were significant contextual variables in the model. All bivariate associations involving the components of negative affect were as hypothesized. That is, poorer quality of life was associated with a greater depressogenic attributional style, higher hopelessness depression, and lower optimism. The structural equation model demonstrated significant direct effects of depressogenic attributional style and hopelessness depression on quality of life, while (lack of) optimism contributed to quality of life indirectly by way of these variables.

Conclusion

The recognition of negative affect presentations among patients, and an understanding of its relevance to diabetes-related quality of life, is a valuable tool for the practitioner.

Citations

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Menopoz dönemindeki diyabetik kadınlarda yaşanılan semptomların yaşam kalitesi parametreleri üzerindeki etkisinin incelenmesi (Prospektif Tek Grup Çalışma)
Ayşegül KOÇ, Betül ÇAKMAK, Birgül GENÇ
Turkish Journal of Diabetes and Obesity.2021; 5(2): 137. CrossRef
Type 1 Diabetes Home Care Project and Educational Consultation
Eun Chong Shin
The Journal of Korean Diabetes.2020; 21(2): 88. CrossRef
Poorer Quality of Life and Treatment Satisfaction is Associated with Diabetic Retinopathy in Patients with Type 1 Diabetes without Other Advanced Late Complications
Minerva Granado-Casas, Esmeralda Castelblanco, Anna Ramírez-Morros, Mariona Martín, Nuria Alcubierre, Montserrat Martínez-Alonso, Xavier Valldeperas, Alicia Traveset, Esther Rubinat, Ana Lucas-Martin, Marta Hernández, Núria Alonso, Didac Mauricio
Journal of Clinical Medicine.2019; 8(3): 377. CrossRef
Is Diabetes & Metabolism Journal Eligible to Be Indexed in MEDLINE?
Sun Huh
Diabetes & Metabolism Journal.2018; 42(6): 472. CrossRef

Complications
Renoprotective Effect of Gemigliptin, a Dipeptidyl Peptidase-4 Inhibitor, in Streptozotocin-Induced Type 1 Diabetic Mice: Gwon-Soo Jung, Jae-Han Jeon, Mi Sun Choe, Sung-Woo Kim, In-Kyu Lee, Mi-Kyung Kim, Keun-Gyu Park; Diabetes Metab J. 2016;40(3):211-221. Published online March 31, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.3.211

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Background

Dipeptidyl peptidase-4 (DPP-4) inhibitors are widely used in the treatment of patients with type 2 diabetes and have proven protective effects on diabetic kidney disease (DKD). Whether DPP-4 inhibitors have renoprotective effects on insulin-deficient type 1 diabetes has not been comprehensively examined. The aim of this study was to determine whether gemigliptin, a new DPP-4 inhibitor, has renoprotective effects in streptozotocin (STZ)-induced type 1 diabetic mice.

Methods

Diabetes was induced by intraperitoneal administration of a single dose of STZ. Mice with diabetes were treated without or with gemigliptin (300 mg/kg) for 8 weeks. Morphological changes of the glomerular basement membrane (GBM) were observed by electron microscopy and periodic-acid Schiff staining. In addition, we measured blood glucose and urinary albumin excretion and evaluated fibrotic markers using immunohistochemical staining, quantitative reverse transcription polymerase chain reaction analysis, and Western blot analysis.

Results

Gemigliptin did not reduce the blood glucose levels of STZ-treated mice. In gemigliptin-treated mice with STZ, a significant reduction in urinary albumin excretion and GBM thickness was observed. Immunohistological examination revealed that gemigliptin attenuated renal fibrosis induced by STZ and decreased extracellular matrix protein levels, including those of type I collagen and fibronectin, and Smad3 phosphorylation. In cultured rat renal cells, gemigliptin inhibited transforming growth factor β-stimulated type I collagen and fibronectin mRNA and protein levels via down-regulation of Smad3 phosphorylation.

Conclusion

Our data demonstrate that gemigliptin has renoprotective effects on DKD, regardless of its glucose-lowering effect, suggesting that it could be used to prevent DKD, including in patients with type 1 diabetes.

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Decoding the Ultimate Effects of Dipeptidyl Peptidase‐4 Inhibitors on Angiogenesis: An Updated Comprehensive Review of the Cellular and Molecular Mechanisms
Andrew Z. Zaka, Safwat A. Mangoura, Marwa A. Ahmed, Beshoy Allam
ChemistrySelect.2025;[Epub] CrossRef
Exendin-4, a glucagon-like peptide-1 receptor agonist, alleviates muscular dysfunction and wasting in a streptozotocin-induced diabetic mouse model compared to metformin
Ding-Cheng Chan, Yuan-Cheng Lin, Huei-Ping Tzeng, Rong-Sen Yang, Meng-Tsan Chiang, Shing-Hwa Liu
Tissue and Cell.2024; 89: 102479. CrossRef
Gemigliptin mitigates TGF-β-induced renal fibrosis through FGF21-mediated inhibition of the TGF-β/Smad3 signaling pathway
Jun-Kyu Byun, Gwon-Soo Jung
Biochemical and Biophysical Research Communications.2024; 733: 150425. CrossRef
Safety and Efficiency of Dipeptidyl Peptidase IV Inhibitors in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis
Adili Tuersun, Munire Mohetaer, Guanxin Hou, Gang Cheng
Current Therapeutic Research.2024; 101: 100763. CrossRef
Diabetic fibrosis
Izabela Tuleta, Nikolaos G. Frangogiannis
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Protective roles of thymoquinone and vildagliptin in manganese-induced nephrotoxicity in adult albino rats
Heba El-Sayed Mostafa, Eman Ahmed Alaa El-Din, Dalia Abdallah El-Shafei, Nehal S. Abouhashem, Aisha Abdallah Abouhashem
Environmental Science and Pollution Research.2021; 28(24): 31174. CrossRef
Evogliptin, a Dipeptidyl Peptidase-4 Inhibitor, Attenuates Renal Fibrosis Caused by Unilateral Ureteral Obstruction in Mice
Mi-Jin Kim, Na-young Kim, Yun-A Jung, Seunghyeong Lee, Gwon-Soo Jung, Jung-Guk Kim, In-Kyu Lee, Sungwoo Lee, Yeon-Kyung Choi, Keun-Gyu Park
Diabetes & Metabolism Journal.2020; 44(1): 186. CrossRef
Gemigliptin Attenuates Renal Fibrosis Through Down-Regulation of the NLRP3 Inflammasome
Jung Beom Seo, Yeon-Kyung Choi, Hye-In Woo, Yun-A Jung, Sungwoo Lee, Seunghyeong Lee, Mihyang Park, In-Kyu Lee, Gwon-Soo Jung, Keun-Gyu Park
Diabetes & Metabolism Journal.2019; 43(6): 830. CrossRef
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Sungmi Park, Hyeon-Ji Kang, Jae-Han Jeon, Min-Ji Kim, In-Kyu Lee
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Vikram Rao A/L B Vasanth Rao, Sean Hong Tan, Mayuren Candasamy, Subrat Kumar Bhattamisra
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Katarina Tomovic, Jelena Lazarevic, Gordana Kocic, Marina Deljanin‐Ilic, Marko Anderluh, Andrija Smelcerovic
Medicinal Research Reviews.2019; 39(1): 404. CrossRef
Effects of Dipeptidyl Peptidase-4 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis
Jae Hyun Bae, Sunhee Kim, Eun-Gee Park, Sin Gon Kim, Seokyung Hahn, Nam Hoon Kim
Endocrinology and Metabolism.2019; 34(1): 80. CrossRef
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Kelly R. McHugh, Adam D. DeVore, Robert J. Mentz, Daniel Edmonston, Jennifer B. Green, Adrian F. Hernandez
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Samuel Mon-Wei Yu, Joseph V. Bonventre
Advances in Chronic Kidney Disease.2018; 25(2): 166. CrossRef
Recombinant human GLP-1(rhGLP-1) alleviating renal tubulointestitial injury in diabetic STZ-induced rats
Weiqin Yin, Shiqing Xu, Zai Wang, Honglin Liu, Liang Peng, Qing Fang, Tingting Deng, Wenjian Zhang, Jinning Lou
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American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.2018; 314(6): R834. CrossRef
Renoprotective effect of fucoidan from Acaudina molpadioides in streptozotocin/high fat diet-induced type 2 diabetic mice
Shiwei Hu, Jinhui Wang, Jingfeng Wang, Shijie Li, Wei Jiang, Yu Liu
Journal of Functional Foods.2017; 31: 123. CrossRef
Dipeptidyl peptidase-4 inhibition and renoprotection
Yuta Takagaki, Daisuke Koya, Keizo Kanasaki
Current Opinion in Nephrology and Hypertension.2017; 26(1): 56. CrossRef
Treatment of diabetic kidney disease: current and future targets
Mi-Kyung Kim
The Korean Journal of Internal Medicine.2017; 32(4): 622. CrossRef
Pharmacological Treatment in Diabetes Mellitus Type 1 – Insulin and What Else?
Ewa Otto-Buczkowska, Natalia Jainta
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GLP-1 and the kidney: from physiology to pharmacology and outcomes in diabetes
Marcel H. A. Muskiet, Lennart Tonneijck, Mark M. Smits, Michaël J.B. van Baar, Mark H. H. Kramer, Ewout J. Hoorn, Jaap A. Joles, Daniël H. van Raalte
Nature Reviews Nephrology.2017; 13(10): 605. CrossRef
Efficacy, safety and albuminuria‐reducing effect of gemigliptin in Korean type 2 diabetes patients with moderate to severe renal impairment: A 12‐week, double‐blind randomized study (the GUARD Study)
Sun A. Yoon, Byoung G. Han, Sung G. Kim, Sang Y. Han, Young I. Jo, Kyung H. Jeong, Kook H. Oh, Hyeong C. Park, Sun H. Park, Shin W. Kang, Ki R. Na, Sun W. Kang, Nam H. Kim, Young H. Jang, Seong H. Shin, Dae R. Cha
Diabetes, Obesity and Metabolism.2017; 19(4): 590. CrossRef
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Eun-Sol Lee, Dong-Sung Lee, Prakash Raj Pandeya, Youn-Chul Kim, Dae-Gil Kang, Ho-Sub Lee, Byung-Chul Oh, Dae Ho Lee
The Korean Journal of Physiology & Pharmacology.2017; 21(5): 519. CrossRef
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Epidemiology of Type 1 Diabetes Mellitus in Korea through an Investigation of the National Registration Project of Type 1 Diabetes for the Reimbursement of Glucometer Strips with Additional Analyses Using Claims Data: Sun Ok Song, Young Duk Song, Joo Young Nam, Kyeong Hye Park, Ji-Hae Yoon, Kyung-Mi Son, Young Ko, Dong-Ha Lim; Diabetes Metab J. 2016;40(1):35-45. Published online December 1, 2015; DOI: https://doi.org/10.4093/dmj.2016.40.1.35

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Abstract PDF Supplementary Material PubReader ePub

Background

The aim of this study was to estimate the prevalence and incidence of type 1 diabetes mellitus (T1DM) in Korea. In addition, we planned to do a performance analysis of the Registration Project of Type 1 diabetes for the reimbursement of consumable materials.

Methods

To obtain nationwide data on the incidence and prevalence of T1DM, we extracted claims data from July 2011 to August 2013 from the Registration Project of Type 1 diabetes on the reimbursement of consumable materials in the National Health Insurance (NHI) Database. For a more detailed analysis of the T1DM population in Korea, stratification by gender, age, and area was performed, and prevalence and incidence were calculated.

Results

Of the 8,256 subjects enrolled over the 26 months, the male to female ratio was 1 to 1.12, the median age was 37.1 years, and an average of 136 new T1DM patients were registered to the T1DM registry each month, resulting in 1,632 newly diagnosed T1DM patients each year. We found that the incidence rate of new T1DM cases was 3.28 per 100,000 people. The average proportion of T1DM patients compared with each region's population was 0.0125%. The total number of insurance subscribers under the universal compulsory NHI in Korea was 49,662,097, and the total number of diabetes patients, excluding duplication, was 3,762,332.

Conclusion

The prevalence of T1DM over the course of the study was approximately 0.017% to 0.021% of the entire population of Korea, and the annual incidence of T1DM was 3.28:100,000 overall and 3.25:100,000 for Koreans under 20 years old.

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The Level of Autoantibodies Targeting Eukaryote Translation Elongation Factor 1 α1 and Ubiquitin-Conjugating Enzyme 2L3 in Nondiabetic Young Adults: Eunhee G. Kim, Soo Heon Kwak, Daehee Hwang, Eugene C. Yi, Kyong Soo Park, Bo Kyung Koo, Kristine M. Kim; Diabetes Metab J. 2016;40(2):154-160. Published online November 13, 2015; DOI: https://doi.org/10.4093/dmj.2016.40.2.154

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Background

The prevalence of novel type 1 diabetes mellitus (T1DM) antibodies targeting eukaryote translation elongation factor 1 alpha 1 autoantibody (EEF1A1-AAb) and ubiquitin-conjugating enzyme 2L3 autoantibody (UBE2L3-AAb) has been shown to be negatively correlated with age in T1DM subjects. Therefore, we aimed to investigate whether age affects the levels of these two antibodies in nondiabetic subjects.

Methods

EEF1A1-AAb and UBE2L3-AAb levels in nondiabetic control subjects (n=150) and T1DM subjects (n=101) in various ranges of age (18 to 69 years) were measured using an enzyme-linked immunosorbent assay. The cutoff point for the presence of each autoantibody was determined based on control subjects using the formula: [mean absorbance+3×standard deviation].

Results

In nondiabetic subjects, there were no significant correlations between age and EEF1A1-AAb and UBE2L3-AAb levels. However, there was wide variation in EEF1A1-AAb and UBE2L3-AAb levels among control subjects <40 years old; the prevalence of both EEF1A1-AAb and UBE2L3-AAb in these subjects was 4.4%. When using cutoff points determined from the control subjects <40 years old, the prevalence of both autoantibodies in T1DM subjects was decreased (EEFA1-AAb, 15.8% to 8.9%; UBE2L3-AAb, 10.9% to 7.9%) when compared to the prevalence using the cutoff derived from the totals for control subjects.

Conclusion

There was no association between age and EEF1A1-AAb or UBE2L3-AAb levels in nondiabetic subjects. However, the wide variation in EEF1A1-AAb and UBE2L3-AAb levels apparent among the control subjects <40 years old should be taken into consideration when determining the cutoff reference range for the diagnosis of T1DM.

Citations

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An autoantigen-ome from HS-Sultan B-Lymphoblasts offers a molecular map for investigating autoimmune sequelae of COVID-19
Julia Y. Wang, Wei Zhang, Victor B. Roehrl, Michael W. Roehrl, Michael H. Roehrl, Mibel Aguilar
Australian Journal of Chemistry.2023; 76(8): 525. CrossRef
An Autoantigen Atlas From Human Lung HFL1 Cells Offers Clues to Neurological and Diverse Autoimmune Manifestations of COVID-19
Julia Y. Wang, Wei Zhang, Victor B. Roehrl, Michael W. Roehrl, Michael H. Roehrl
Frontiers in Immunology.2022;[Epub] CrossRef
Prevalence of antibodies targeting ubiquitin-conjugating enzyme 2L3 and eukaryote translation elongation factor 1 α1 in Chinese Han and American Caucasian populations with type 1 diabetes
Li Qian, Yuxiao Zhu, Yan Luo, Mu Zhang, Liping Yu, Yu Liu, Tao Yang
Endocrine Connections.2022;[Epub] CrossRef
An autoantigen profile of human A549 lung cells reveals viral and host etiologic molecular attributes of autoimmunity in COVID-19
Julia Y. Wang, Wei Zhang, Michael W. Roehrl, Victor B. Roehrl, Michael H. Roehrl
Journal of Autoimmunity.2021; 120: 102644. CrossRef

Maternal and Neonatal Outcomes in Korean Women with Type 1 and Type 2 Diabetes: Hee-Sook Kim, Hye-Jung Jang, Jeong-Eun Park, Moon-Young Kim, Sun-Young Ko, Sung-Hoon Kim; Diabetes Metab J. 2015;39(4):316-320. Published online August 17, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.4.316

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Background

The purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes.

Methods

We performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (n=13) and type 2 diabetes (n=150) treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups.

Results

Differences in glycosylated hemoglobin between type 1 and type 2 diabetes were not significant. Birth weight (3,501±689.6 g vs. 3,366±531.4 g) and rate of major congenital malformations (7.7% vs. 5.6%) were not significantly different. However, women with type 1 diabetes had higher rates of preeclampsia (38.5% vs. 8.2%, P=0.006), large for gestational age (LGA; 46.2% vs. 20.4%, P=0.004), macrosomia (38.5% vs. 13.4%, P=0.032), and admission for neonatal care (41.7% vs. 14.8%, P=0.03) than women with type 2 diabetes.

Conclusion

Maternal and neonatal outcomes for women with type 1 diabetes were poorer than for women with type 2 diabetes, especially preeclampsia, LGA, macrosomia and admission to the neonatal intensive care unit.

Citations

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Prevalence of congenital anomalies in pregnancies complicated by type 2 diabetes: Systematic review and meta‐analysis
Maria Lúcia R. Oppermann, Maria Amélia A. Campos, Giulia L. Guerra, Vânia N. Hirakata, Viviane C. Castanho, Francieli Ariane L. Muck, Angela J. Reichelt
International Journal of Gynecology & Obstetrics.2026; 172(1): 196. CrossRef
Usefulness of glycated albumin levels in predicting the maternal or neonatal complications of gestational diabetes mellitus during ;ate pregnancy in South Korea: a retrospective study
Jihan Kim, Sami Lee, Jong Sung Kim
Korean Journal of Family Medicine.2025; 46(6): 401. CrossRef
Glycosylated Hemoglobin Levels in the Third Trimester for Predicting Adverse Pregnancy and Neonatal Outcomes in Women with Pre-Gestational Diabetes: A Multi-Center Retrospective Cohort Study in South Korea
Su-Yeon Park, Mi-Ju Kim, Su-Been Hong, Ji-Hee Sung, Hyun-Joo Seol, Joon-Ho Lee, Seung-Chul Kim, Seung-Mi Lee, Se-Jin Lee, Han-Sung Hwang, Gi-Su Lee, Hyun-Soo Park, Soo-Jeong Lee, Sae-Kyung Choi, Ji-Young Kwon, Geum-Joon Cho, Soo-Ran Choi, Hyun-Sun Ko
Journal of Clinical Medicine.2025; 14(18): 6389. CrossRef
Fetal malformations in women with pregestational diabetes mellitus based on pre-pregnancy fasting plasma glucose levels
Subeen Hong, Kyung A. Lee, Young Mi Jung, Heechul Jeong, Ji-Hee Sung, Hyun-Joo Seol, Won Joon Seong, Soo Ran Choi, Joon Ho Lee, Seung Chul Kim, Sae-Kyoung Choi, Ji Young Kwon, Hyun Soo Park, Hyun Sun Ko, Geum Joon Cho
Scientific Reports.2025;[Epub] CrossRef
The Impact of Type 2 Diabetes on Women’s Health and Well-being During Their Reproductive Years: A Mixed-methods Systematic Review
Aycan Celik, Rita Forde, Simona Racaru, Angus Forbes, Jackie Sturt
Current Diabetes Reviews.2022;[Epub] CrossRef
Application of the electronic nose in predicting preeclampsia in high-risk pregnancies. Pilot study
Karen Beatriz Méndez Rodríguez, Luis Manuel Ramírez Gómez, Leticia Carrizales Yáñez, Rogelio Flores Ramírez, Omar Ornelas-Rebolledo, Jaime Antonio Borjas-García, Francisco Pérez-Vázquez, Maribel Rodríguez Aguilar
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Obstetric and neonatal complications among women with autoimmune disease
Andrew Williams, Katherine Grantz, Indulaxmi Seeni, Candace Robledo, Shanshan Li, Marion Ouidir, Carrie Nobles, Pauline Mendola
Journal of Autoimmunity.2019; 103: 102287. CrossRef
Effects of maternal age, parity and pre-pregnancy body mass index on the glucose challenge test and gestational diabetes mellitus
Adel T. Abu-Heija, Majeda R. Al-Bash, Moza A. Al-Kalbani
Journal of Taibah University Medical Sciences.2017; 12(4): 338. CrossRef
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Nicolás Santander, Carlos Lizama, María José Parga, Alonso Quiroz, Druso Pérez, Guadalupe Echeverría, Lorena Ulloa, Verónica Palma, Attilio Rigotti, Dolores Busso
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Selective Immunoglobulin A Deficiency in Type 1 Diabetes Mellitus: A Prevalence Study in Western Sicily (Italy): Domenico Greco, Filippo Maggio; Diabetes Metab J. 2015;39(2):132-136. Published online March 10, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.2.132

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Background

The association between type 1 diabetes and immunoglobulin A deficiency (IgA-D) has long been recognized in many populations. The aim of this study was to assess the prevalence of IgA-D in patients with type 1 diabetes mellitus all coming from a defined geographical area and to investigate the clinical features of these subjects.

Methods

The records of 150 consecutive patients with type 1 diabetes mellitus referred in a period of one year were analyzed. A detailed history was obtained for each patient. Information was collected concerning age, gender, time of onset of diabetes, and presence of other autoimmune diseases.

Results

Out of 150 patients with type 1 diabetes, eight (5.3%) had a diagnosis of IgA-D. There were one female and seven male; all these patients were diagnosed by screening: none of them had history of recurrent infections. Autoimmune thyroiditis was coexisting in five patients (62%). Although other associated autoimmune disorders were found in a number of patients, there was no different prevalence rate in IgA deficient patients.

Conclusion

This study shows the prevalence of IgA-D in Sicilian patients with type 1 diabetes as 5.3% which is much higher than reported in other Italian studies. Moreover, our data show a high prevalence of IgA-D in male gender and describe thyroiditis as the most frequent autoimmune disease present in these patients. Finally, in our case report, IgA-D diagnosis always followed routine IgA measurement when case finding for celiac disease with no history of recurrent infections in each patient.

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Meta‐Analysis: Global Prevalence of Coeliac Disease in Type 1 Diabetes
Sahand Karimzadhagh, Elahe Abbaspour, Maryam Shahriarinamin, Pourya Shamsi, Selvana Poursadrolah, Mehrdad Khorasani, Mahzad Daghighi, Arash Malek, Jouan Taheri Talesh, Govind K. Makharia, Mohammad Rostami‐Nejad
Alimentary Pharmacology & Therapeutics.2025; 61(1): 8. CrossRef
Diabetic ketosis vs ketoacidosis as initial presentation of pediatric type 1 diabetes mellitus. Associated features and rate of progression during the first two years after diagnosis
Aristeidis Giannakopoulos, Natasa Chrysanthakopoulou, Alexandra Efthymiadou, Dionisios Chrysis
Journal of Diabetes and its Complications.2024; 38(1): 108667. CrossRef
Role of liver parameters in diabetes mellitus – a narrative review
Sana Rafaqat, Aqsa Sattar, Amber Khalid, Saira Rafaqat
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The Prevalence of Selective and Partial Immunoglobulin A Deficiency in Patients with Autoimmune Polyendocrinopathy
Mahnaz Jamee, Mohammad Reza Alaei, Mehrnaz Mesdaghi, Shahab Noorian, Mehdi Moosavian, Elahe Dolatshahi, Habibeh Taghavi Kojidi, Zahra Chavoshzadeh, Mazdak Fallahi, Samaneh Parviz, Fatemeh Aghamahdi, Gholamreza Azizi
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Selective immunoglobulin A deficiency in children with diabetes mellitus: Data from a medical center in Ukraine
Oksana Boyarchuk, Lesya Dobrovolska, Halyna Svystunovych, Elsayed Abdelkreem
PLOS ONE.2022; 17(11): e0277273. CrossRef
Clinical heterogeneity among pediatric patients with autoimmune type 1 diabetes stratified by immunoglobulin deficiency
Anna Hogendorf, Małgorzata Szymańska, Joanna Krasińska, Anna Baranowska‐Jaźwiecka, Marta Ancuta, Anna Charubczyk, Krystyna Wyka, Izabela Drozdz, Magdalena Sokolowska‐Gadoux, Joanna Zarebska, Arkadiusz Michalak, Agnieszka Szadkowska, Przemysława Jarosz‐Cho
Pediatric Diabetes.2021; 22(5): 707. CrossRef
Levels of Salivary Immunoglobulin a and Immunoglobulin G in Type 2 Diabetic Patients
Olatunde A. Olayanju, Olabisi Bamidele, Bola J. Eseile, Chioma Udeh, Gabriel N. Odok, Nnaemeka E. Awah, Izuchukwu N. Mba, Fayeofori M. Abbiyesuku
Nigerian Journal of Medicine.2021; 30(6): 665. CrossRef
Late-Onset T1DM and Older Age Predict Risk of Additional Autoimmune Disease
Jing W. Hughes, Yicheng K. Bao, Maamoun Salam, Prajesh Joshi, C. Rachel Kilpatrick, Kavita Juneja, David Nieves, Victoria Bouhairie, Olivia J. Jordan, Erica C. Blustein, Garry S. Tobin, Janet B. McGill
Diabetes Care.2019; 42(1): 32. CrossRef
Circulating B cells in type 1 diabetics exhibit fewer maturation-associated phenotypes
Patrick Hanley, Jennifer A. Sutter, Noah G. Goodman, Yangzhu Du, Debora R. Sekiguchi, Wenzhao Meng, Michael R. Rickels, Ali Naji, Eline T. Luning Prak
Clinical Immunology.2017; 183: 336. CrossRef

1,5-Anhydroglucitol as a Useful Marker for Assessing Short-Term Glycemic Excursions in Type 1 Diabetes: Hannah Seok, Ji Hye Huh, Hyun Min Kim, Byung-Wan Lee, Eun Seok Kang, Hyun Chul Lee, Bong Soo Cha; Diabetes Metab J. 2015;39(2):164-170. Published online March 9, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.2.164

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Background

Type 1 diabetes is associated with more severe glycemic variability and more frequent hypoglycemia than type 2 diabetes. Glycemic variability is associated with poor glycemic control and diabetic complications. In this study, we demonstrate the clinical usefulness of serum 1,5-anhydroglucitol (1,5-AG) for assessing changes in glycemic excursion in type 1 diabetes.

Methods

Seventeen patients with type 1 diabetes were enrolled in this study. A continuous glucose monitoring system (CGMS) was applied twice at a 2-week interval to evaluate changes in glycemic variability. The changes in serum glycemic assays, including 1,5-AG, glycated albumin and hemoglobin A1c (HbA1c), were also evaluated.

Results

Most subjects showed severe glycemic excursions, including hypoglycemia and hyperglycemia. The change in 1,5-AG level was significantly correlated with changes in the glycemic excursion indices of the standard deviation (SD), mean amplitude of glucose excursion (MAGE), lability index, mean postmeal maximum glucose, and area under the curve for glucose above 180 mg/dL (r=-0.576, -0.613, -0.600, -0.630, and -0.500, respectively; all P<0.05). Changes in glycated albumin were correlated with changes in SD and MAGE (r=0.495 and 0.517, respectively; all P<0.05). However, changes in HbA1c were not correlated with any changes in the CGMS variables.

Conclusion

1,5-AG may be a useful marker for the assessment of short-term changes in glycemic variability. Furthermore, 1,5-AG may have clinical implications for the evaluation and treatment of glycemic excursions in type 1 diabetes.

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