AbstractInsulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non‐insulin‐dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase. Dipeptidyl peptidase‐4 inhibitors and biguanides might be the treatment of choice for SPIDDM (probable), but no evidence exists for other hypoglycemic agents. In any case, careful monitoring of the endogenous insulin secretion capacity should be carried out, and if a decrease in insulin secretion capacity is suspected, a change in treatment should be considered to prevent progression to an insulin‐dependent state.

ABSTRACTAims/IntroductionWe evaluated the effect of the MiniMed™ 770G, an insulin pump using hybrid closed‐loop technology, on blood glucose management and quality of life in Japanese people with type 1 diabetes.Materials and MethodsThis was a 52‐week, prospective, observational study. Fifty Japanese people with type 1 diabetes switched from the MiniMed™ 640G to 770G, and we analyzed the continuous glucose monitoring data of 24 subjects who used auto mode throughout the study. We also analyzed the scores of the Diabetes Therapy‐Related Quality of Life questionnaire completed by 26 auto‐mode users before and after the treatment change.ResultsThe baseline time in range 70–180 mg/dL was 67.3 (54.8–78.4)%, with a significant improvement beginning 8 weeks after the switch and lasting until 52 weeks. The baseline time below range <70 mg/dL was 1.9 (0.6–3.6)%, with a significant increase at week 8; however, the mean value was less than 4% throughout the study period. On the other hand, the number of blood glucose measurements significantly increased. While there was no significant difference in the overall change in the total Diabetes Therapy‐Related Quality of Life score, there was a significant decrease in the treatment satisfaction score.ConclusionsUse of the MiniMed™ 770G improved continuous glucose monitoring metrics. However, treatment satisfaction decreased, probably due to the increased frequency of blood glucose monitoring necessary to maintain auto mode.

This study aimed to assess the correlation between hip circumference (HC) and the risk of cardiovascular disease (CVD) and type 2 diabetes mellitus using Mendelian randomization (MR) to overcome observational study limitations. MR analysis utilized genetic variation from the MR Base in a two-sample analysis. Three methods were employed: MR-Egger regression, weighted median estimator, and inverse variance weighting (IVW). Data was acquired from MR Base, a platform summarizing genome-wide association study (GWAS) data for MR research. Publicly available summary statistics datasets from GWAS meta-analyses were used, with HC and HC adjusted for body mass index (BMI) as exposures. Data for CVD and type 2 diabetes mellitus were obtained as outcomes. Results indicated a positive causal relationship between HC and CVD (IVW: P = 1.84e-07, OR: 1.37, 95% CI: 1.22-1.54) as well as type 2 diabetes mellitus (IVW: P = 0.04, OR: 1.62, 95% CI: 1.02-2.56), independent of BMI. However, HC after BMI adjustment showed no significant causal relationship with CVD (IVW: P = 0.05, OR: 1.09, 95% CI: 1.00-1.19) and exhibited a negative association with type 2 diabetes mellitus (IVW: P = 0.00, OR: 0.76, 95% CI: 0.66-0.88), suggesting a protective effect against type 2 diabetes mellitus. After adjusting for BMI, adipose tissue concentrated in the hip region showed a protective effect against type 2 diabetes mellitus but not against CVD. These findings offer insights into diabetes prevention and treatment strategies, and may inform plastic surgery procedures. Further research is needed to validate these findings and explore underlying mechanisms.

Previous studies have shown higher cardiovascular mortality risk with higher monocyte-lymphocyte ratio levels in general population. However, the levels of oxidative stress in individuals with type 2 diabetes are higher than those in the general population, which may affect the link between monocyte-to-lymphocyte ratio and cardiovascular disease deaths. And the association between the monocyte-to-lymphocyte ratio and mortality risk in people with type 2 diabetes still be unknown. This study aimed to investigate the prognostic significance of monocyte-to-lymphocyte ratio in type 2 diabetes. This analysis involved 2,954 individuals with type 2 diabetes from the National Health and Nutrition Examination Survey 1999-2010. The National Death Index records through December 31, 2019, was used to determine all-cause and cardiovascular mortality. The prognostic roles were determined using Cox regression models, restricted cubic spline analysis, and time-dependent receiver operating characteristic curve analysis. During an average follow-up period of 12.4 years, a total of 1,007 deaths occurred, while 252 were due to cardiovascular disease. An elevated monocyte-to-lymphocyte ratio level exhibited a significant dose-response relationship with an increased risk of all-cause mortality (1.34 [95% CI 1.12, 1.60] for all-cause mortality [Ptrend = 0.001]). The multivariable-adjusted HR was 1.81 (95% CI 1.25, 2.63) (Ptrend = 0.001) for cardiovascular mortality indicating a U-shaped relationship (Pnonlinear = 0.013). The results of this study indicate a U-shaped relationship between the monocyte-to-lymphocyte ratio and cardiovascular mortality in individuals with diabetes. Both very low and high monocyte-to-lymphocyte ratio monocyte-to-lymphocyte ratio values were found to be associated with increased cardiovascular mortality risk.

The aim of this study was to identify a metabolic signature of MIDD as compared to healthy controls and other types of diabetes. We performed a comprehensive serum metabolomic analysis using gas chromatography-time of flight mass spectrometry (GC-TOFMS) in participants diagnosed with MIDD (n = 14), latent autoimmune diabetes in adults (LADA) (n = 14), type 2 diabetes mellitus (n = 14), and healthy controls (n = 14). Each group was matched for gender and age. There were significant metabolic differences among MIDD and other diabetic and control groups. Compared with control, MIDD patients had high levels of carbohydrates (glucose, galactose, mannose, sorbose, and maltose), fatty acids (2-Hydroxybutyric acid, eicosapentaenoic acid, and octadecanoic acid), and other metabolites (alanine, threonic acid, cholesterol, lactic acid, and gluconic acid), but low level of threonine. Compared with LADA, MIDD patients had high levels of threonic acid and some amino acids (alanine, tryptophan, histidine, proline, glutamine, and creatine) but low levels of serine. Compared with type 2 diabetes mellitus, MIDD patients had high levels of citrulline, creatine, 3-Amino-2-piperidone, but low levels of ornithine, fatty acids (arachidonic acid and octadecanoic acid), and intermediates of the tricarboxylic acid cycle (malic acid and succinic acid). Our study identified a specific metabolic profile related to glycolysis and the tricarboxylic acid cycle in MIDD that differs from healthy controls and other types of diabetes. This unique metabolic signature provides new perspectives for understanding the pathophysiology and underlying mechanisms of MIDD.