Highlights

• Evidence for contribution of basal and postprandial glucose increments and glycemic variability to glycated hemoglobin (HbA1c) among adults with type 1 diabetes (T1D) is limited.
• In this study, after analyzing a total of 169 550 sensor-derived data in 2409 meals recorded from 102 T1D adults, we found that basal hyperglycemia (BHG) was four times higher than that of postprandial hyperglycemia (PHG). Factors including BHG, preprandial glycemia, PHG, glycemic variability and age, body mass index, hemoprotein, and duration explained a total of 74% of the variance in HbA1c, in which fasting hyperglycemia accounted for 32.1% of variance and postprandial glycemia accounted for 24.4%.
• The relative contribution of fasting hyperglycemia increased gradually with HbA1c increasing.

Highlights

• This is a systematic review-based clinical practice guideline. After internal and external review, two strong recommendations, six conditional recommendations, and one qualifying statement were made for insulin-naive adult patients with type 2 diabetes. Although the guideline authors came from the Asia-Pacific region, the eligible evidence was based on recent English publications. The recommendations and the clinical thresholds set up in the guideline can be used as references for clinicians worldwide.

Highlights

• Transcutaneous oxygen pressure (TcPO2) could be used to assess microcirculation, which revealed endothelial injury. As endothelial injury is a cause of albuminuria in diabetic kidney disease (DKD), albuminuria and creatinine (ACR) might be employed to assess microcirculation in DKD patients in rural hospital where TcPO2 is not available. Our study showed TcPO2 was significantly lower in patients with ACR >300 mg/g and a negative correlation between TcPO2 and ACR was observed. Further, ACR was an independent influence factor of low TcPO2. On top of that, the area under receiver operating characteristics curve was 0.768 for ACR in predicting TcPO2. The best cutoff value for ACR was 75.25 mg/g and yielded a sensitivity of 71.7% and a specificity of 71.7%. These results suggested ACR could be used as a potential biomarker for assessing microcirculation in DKD patients.

Highlights

• Using a large-scale prospective population-based cohort study, we found that a higher frequency of daytime napping is associated with an increased risk of incident type 2 diabetes (T2D), and such relations are modified by body fat percentage (BFP) and C-reactive protein (CRP) levels. The association between daytime napping and T2D risk is strongest among those with the lowest BFP and CRP levels, which provides implications for the development of T2D prevention strategies targeting the reduction in BFP and CRP levels among adults with napping habits.

Highlights

• All three estimated glomerular filtration rates (GFRs) (based on creatinine [eGFRcr], cystatin C [eGFRcys], or both [eGFRcr-cys]) were more strongly associated with risk of all-cause mortality among individuals with diabetes than among those without diabetes.
• Regardless of diabetes status, eGFRcys and eGFRcr-cys were more strongly associated with risk of all-cause mortality than eGFRcr.
• Regardless of diabetes status, an addition of eGFRcys or eGFRcr-cys to traditional risk factors lead to a larger improvement in the prediction of all-cause mortality risk than adding eGFRcr, which needs to be considered in clinical practices.

Highlights

• For distinguishing glucokinase maturity-onset diabetes of the young (GCK-MODY) from hepatocyte nuclear factor 1-α MODY (HNF1A-MODY), total triglycerides may help during the follow-up period. In order to discriminate GCK-MODY from MODY-like type 2 diabetes, high-sensitivity C-reactive protein may be a suitable indicator in the early stage, whereas HbA1c and fasting blood glucose may not help until the follow-up stage. The role of the aforementioned four indicators for identifying GCK-MODY in the shorter or longer duration from corresponding diabetic forms in the general clinical setting should be reassessed.

Highlights

• Intensive lifestyle intervention decreases A1C and body weight in patients with diabetes by up to 2.5%. At similar magnitude of weight loss, A1C reduction is more prominent in participants with higher baseline A1C.