Effect of applying a diabetes risk score on lifestyle counselling and shared decision-making in primary care: A pragmatic cluster randomised trial.

Aims: There is a lack of studies on the impact of diabetes risk scores on diabetes prevention. The aim of this study was to investigate the effect of applying a non-invasive diabetes risk score as component of routine health checks on counselling intensity and shared decision-making (SDM) in primary care.

Methods: Cluster randomised trial, in which primary care physicians (n = 30) enrolled participants (n = 315) with statutory health insurance without known diabetes, ≥ 35 years of age with a body mass index (BMI) ≥ 27.

Determinants of increased muscle insulin sensitivity of exercise-trained versus sedentary normal weight and overweight individuals.

The athlete's paradox states that intramyocellular triglyceride accumulation associates with insulin resistance in sedentary but not in endurance-trained humans. Underlying mechanisms and the role of muscle lipid distribution and composition on glucose metabolism remain unclear. We compared highly trained athletes (ATHL) with sedentary normal weight (LEAN) and overweight-to-obese (OVWE) male and female individuals.

Built-in selection or confounder bias? Dynamic Landmarking in matched propensity score analyses.

Background: Propensity score matching has become a popular method for estimating causal treatment effects in non-randomized studies. However, for time-to-event outcomes, the estimation of hazard ratios based on propensity scores can be challenging if omitted or unobserved covariates are present. Not accounting for such covariates could lead to treatment estimates, differing from the estimate of interest.

Hybrid closed-loop insulin therapy and risk of severe hypoglycaemia and diabetic ketoacidosis in young people (aged 2-20 years) with type 1 diabetes: a population-based study.

Background: The effect of closed-loop insulin delivery on the risk of acute diabetes complications in people with type 1 diabetes is unclear. We investigated whether the rates of severe hypoglycaemia and diabetic ketoacidosis are lower with hybrid closed-loop insulin therapy compared with sensor-augmented (open-loop) pump therapy in a large cohort of young people.

Methods: In this population-based cohort study, we evaluated young people with type 1 diabetes from 250 diabetes centres in Germany, Austria, Switzerland, and Luxembourg participating in the Diabetes Prospective Follow-up (DPV) initiative.

The potential of precision diabetology for type 2 diabetes treatment-evidence from a meta-regression for all-cause mortality from large cardiovascular outcome trials.

Aims: Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials.

The role of exosomes for sustained specific cardiorespiratory and metabolic improvements in males with type 2 diabetes after detraining.

Background: High-intensity interval training (HIIT) has been shown to improve cardiorespiratory fitness (V˙O max) but may ameliorate insulin sensitivity only in insulin-resistant humans. It is yet unclear whether these benefits persist after detraining and to which extent duration and effectiveness of metabolic improvements differ between individuals without and with prediabetes or type 2 diabetes (T2D). Understanding these differences is relevant for developing targeted exercise training modes for individuals with different stages of dysglycemia.

Optimising the treatment of chronic ischemic heart disease by training general practitioners to deliver very brief advice on physical activity (OptiCor): protocol of the systematic development and evaluation of a complex intervention.

Background: Chronic ischemic heart disease (IHD) is one of the leading causes of morbidity and mortality. Physical activity (PA) is an effective secondary preventive strategy in IHD management. The German treatment guideline recommends that general practitioners (GPs) deliver PA advice to patients.

Prediction Model for Polyneuropathy in Recent-Onset Diabetes Based on Serum Neurofilament Light Chain, Fibroblast Growth Factor-19 and Standard Anthropometric and Clinical Variables.

Background: Diabetic sensorimotor polyneuropathy (DSPN) is often asymptomatic and remains undiagnosed. The ability of clinical and anthropometric variables to identify individuals likely to have DSPN might be limited. Here, we aimed to integrate protein biomarkers for reliably predicting present DSPN.

Evaluation of spatiotemporal associations between COVID-19 pandemic waves and the incidence of pediatric type 1 diabetes in Germany considering time lags: A register-based ecological study.

To analyze the ecological relationship between COVID-19 incidence in the total population and type 1 diabetes (T1D) incidence in children and adolescents, spatiotemporal models were applied considering time lags from 0 to 12 months. The results do not indicate a positive correlation between COVID-19 incidence and T1D incidence.

The mediatory role of androgens on sex differences in glucose homeostasis and incidence of type 2 diabetes: the KORA study.

Background: Sex differences exist in type 2 diabetes (T2D), and androgens have been implicated in the etiology of T2D in a sex-specific manner. We therefore aimed to investigate whether androgens play a role in explaining sex differences in glucose homeostasis and incidence of T2D.

Methods: We used observational data from the German population-based KORA F4 study (n = 1975, mean age: 54 years, 41% women) and its follow-up examination KORA FF4 (median follow-up 6.

Projected number of people in need for long-term care in Germany until 2050.

Introduction: Current demographic trends predict continuously growing numbers of individuals reliant on care, which has to be accounted for in future planning of long-term care-resources. The projection of developments becomes especially necessary in order to enable healthcare systems to cope with this future burden and to implement suitable strategies to deal with the demand of long-term care. This study aimed to project the prevalence of long-term care and the number of care-dependent people in Germany until 2050.

Depression symptoms, wellbeing, health-related quality of life, and diabetes-related distress in novel subtypes of recent-onset diabetes in Germany: a 5-year observational follow-up study.

Background: The subjective experiences of individuals living with diabetes is commonly assessed with patient-reported outcomes (PROs; eg, depression symptoms, wellbeing, health-related quality of life [HRQOL], and diabetes-related distress). Cluster analyses have identified novel diabetes subtypes differing in phenotypic and metabolic characteristics. We aimed to investigate associations between these subtypes and PROs and whether subtype predicted PROs 5 years later.

Subphenotypes of adult-onset diabetes: Data-driven clustering in the population-based KORA cohort.

Aims: A data-driven cluster analysis in a cohort of European individuals with type 2 diabetes (T2D) has previously identified four subgroups based on clinical characteristics. In the current study, we performed a comprehensive statistical assessment to (1) replicate the above-mentioned original clusters; (2) derive de novo T2D subphenotypes in the Kooperative Gesundheitsforschung in der Region Augsburg (KORA) cohort and (3) describe underlying genetic risk and diabetes complications.

Methods: We used data from n = 301 individuals with T2D from KORA FF4 study (Southern Germany).

Role of patatin-like phospholipase domain-containing 3 gene for decreasing kidney function in recently diagnosed diabetes mellitus.

Aims: We examined the association of the G allele in the single-nucleotide polymorphism (SNP) rs738409 in the third exon of patatin-like phospholipase domain-containing 3 gene (PNPLA3) gene, with chronic kidney disease in diabetes endotypes.

Methods: Participants with recent-onset diabetes (n = 707) from the prospective German Diabetes Study (GDS) underwent cluster assignment, detailed phenotyping, genotyping and magnetic resonance spectroscopy to quantify hepatocellular lipid content (HCL).

Results: Severe insulin-resistant diabetes (SIRD) had the lowest glomerular filtration rates (eGFR) and highest HCL compared to severe insulin-deficient, moderate obesity-related, moderate age-related and severe autoimmune diabetes endotypes (all p < 0.

Modeling Chronic Disease Mortality by Methods From Accelerated Life Testing.

We propose a parametric model for describing chronic disease mortality from cohort data and illustrate its use for Type 2 diabetes. The model uses ideas from accelerated life testing in reliability theory and conceptualizes the occurrence of a chronic disease as putting the observational unit to an enhanced stress level, which is supposed to shorten its lifetime. It further addresses the issue of semi-competing risk, that is, the asymmetry of death and diagnosis of disease, where the disease can be diagnosed before death, but not after.

Association of plasma proteomics with mortality in individuals with and without type 2 diabetes: Results from two population-based KORA cohort studies.

Background: Protein biomarkers may contribute to the identification of vulnerable subgroups for premature mortality. This study aimed to investigate the association of plasma proteins with all-cause and cause-specific mortality among individuals with and without baseline type 2 diabetes (T2D) and evaluate their impact on the prediction of all-cause mortality in two prospective Cooperative Health Research in the Region of Augsburg (KORA) studies.

Methods: The discovery cohort comprised 1545 participants (median follow-up 15.

Effects of carotenoid supplementation on glycemic control: a systematic review and meta-analysis of randomized clinical trials.

Objectives: We conducted a systematic review and meta-analysis to assess the effects of carotenoid supplementation on glycemic indices, and the certainty of evidence.

Methods: A systematic literature search in PubMed, SCOPUS, ISI-Web of Science, and Cochrane Library was conducted from inception up to Jun 17, 2024. Randomized controlled trials (RCTs) investigating the effect of carotenoid supplementation on circulating glycemic parameters were included.