Metabolic and clinical markers of T2D in obese Indians: an age-sex matched case-control study

Diet quality and biochemical parameters in individuals with type 2 diabetes across BMI categories: A cross-sectional study.

Exploratory Analysis of Type 2 Diabetes Mellitus Metabolic Phenotypes and Their Association With Vitamin D Status in Primary Care Patients.

The metabolic phenotypes were explored in a primary care T2DM cohort, supporting their reproducibility across clinical settings and vitamin D status varied by phenotype severity, with more severe phenotypes more likely to exhibit insufficiency.

Sarcopenic Obesity and Risk of Incident Type 2 Diabetes: A Prospective Cohort Study and Landmark Analysis From the UK Biobank.

OBJECTIVE To examine whether sarcopenic obesity (SO) is associated with incident type 2 diabetes (T2D) beyond obesity or sarcopenia alone and whether associations differ by sex, age, and transitions in body composition phenotypes over time. RESEARCH DESIGN AND METHODS We studied 479,607 diabetes-free UK Biobank participants. SO was defined using handgrip strength, skeletal muscle mass-to-weight ratio, and fat mass percentage. Cox models estimated hazard ratios (HRs). A landmark analysis (n = 53,107) examined phenotype transitions. RESULTS Over a median follow-up of 14.2 years, T2D developed in 32,948 participants. SO conferred the highest risk (HR 3.54 [95% CI 3.34-3.74]), exceeding obesity alone and sarcopenia alone. Transitioning to SO (HR 2.90 [95% CI 2.07-4.07]) and persistent SO (HR 3.07 [95% CI 1.63-5.79]) both elevated risks. CONCLUSIONS SO was associated with higher T2D risk than obesity or sarcopenia alone, supporting integrated assessment of muscle health and adiposity in T2D risk stratification.

Factors associated with poor glycaemic control among adults with type 2 diabetes mellitus in Albania: a cross-sectional study.

BACKGROUND Poor glycaemic control is common among adults with type 2 diabetes mellitus (T2DM) in low- and middle-income settings in South-Eastern Europe, yet patient-level data on its correlates from Albania are scarce. We examined the demographic, clinical and treatment-related factors associated with poor glycaemic control (HbA1c ≥ 7%) in Albanian adults with T2DM. METHODS Cross-sectional study of 176 consecutive adults with T2DM attending a hospital-based outpatient diabetes service in northern Albania. Poor glycaemic control was defined a priori as HbA1c ≥ 7% (53 mmol/mol). Sociodemographic characteristics, diabetes duration, insulin therapy and physician-confirmed comorbidities were recorded. Associations were assessed using univariate and multivariable logistic regression, estimating odds ratios (OR) with 95% confidence intervals (CI); comorbidity was modelled both as individual conditions (primary model) and as a comorbidity-burden index (sensitivity model). Model calibration and discrimination were evaluated using the Hosmer-Lemeshow test and the area under the ROC curve. RESULTS Mean age was 65 years, 51% were men and mean diabetes duration was 11 years. The prevalence of poor glycaemic control was 58.5% (95% CI 50.9-65.9%), and 54% were receiving insulin. In univariate analyses, poor control was more frequent with insulin therapy (OR 5.64, 95% CI 2.93-10.87), longer diabetes duration (OR 1.42 per 5 years, 1.09-1.85) and ischaemic heart disease (OR 2.10, 1.09-4.08). After mutual adjustment, insulin therapy was the only factor independently associated with poor control (adjusted OR 6.32, 95% CI 2.71-14.71); age, diabetes duration, hypertension, ischaemic heart disease and multimorbidity were not. Results were unchanged in the sensitivity model. The primary model was well calibrated (Hosmer-Lemeshow p = 0.96), with moderate discrimination (area under the ROC curve 0.74). CONCLUSIONS In this Albanian outpatient population, poor glycaemic control was common and insulin therapy was the only factor independently associated with it. This reflects confounding by indication rather than harm from insulin: insulin is initiated when oral therapy no longer maintains targets, so insulin-treated patients form a clinically identifiable subgroup with more advanced disease who warrant priority for structured treatment intensification and individualised follow-up. Prospective multicentre studies are needed to confirm these associations and their temporal direction. TRIAL REGISTRATION Not applicable (observational, non-interventional study).

Obesity in pediatric type 1 diabetes: an underestimated health problem.

AIM To determine the prevalence of overweight and obesity among youth with type 1 diabetes (T1D) in a multi-ethnic cohort and examine associations with clinical characteristics. METHODS We conducted a retrospective study of all participants enrolled in the Accurate Diagnosis in Diabetes for Appropriate Management (ADDAM) Biobank at the Montreal Children's Hospital (n = 352). Logistic regression was used to evaluate associations between overweight/obesity (BMI ≥ 85th percentile for age and sex) and age, sex, diabetes duration, hemoglobin A1C, genetic ancestry, and weight-adjusted total daily insulin dose. RESULTS Overall, 70.5% of participants had BMI < 85th percentile, while 29.5% had BMI ≥ 85th percentile, including 10.7% with obesity (BMI > 95th percentile). Higher weight-adjusted total daily insulin dose was independently associated with BMI ≥ 85th percentile. However, when analyses were restricted to participants with obesity, this association was no longer statistically significant after multivariable adjustment (P = 0.06). CONCLUSIONS Nearly one-third of youth with T1D in this cohort had overweight or obesity. Higher weight-adjusted insulin requirements may reflect increased insulin resistance in this population. Further studies are needed to identify modifiable risk factors and inform obesity prevention strategies in youth with T1D.

Association between visceral adiposity index and metabolic dysfunction-associated steatotic liver disease in adults with type 1 diabetes mellitus: an exploratory cross-sectional study.