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Background: Low muscle mass likely results in reduced capacity for glucose disposal, leading to a significant but under-appreciated contribution to increasing the risk of diabetes. But few prospective studies have investigated the association between the loss of muscle mass and the occurrence of diabetes. We aimed to investigate whether short-term changes in muscle mass affect the incidence of diabetes in a Chinese population. Methods: This study included 1275 individuals without evident diabetes at baseline. In the baseline and re-examination, individuals completed the risk factors survey and underwent body composition measurement. Muscle mass index was defined as the percentage skeletal muscle mass, which was measured by an automatic bioelectric analyzer. Results: After a median follow-up of 2.1 years, 142 individuals developed diabetes (11.1%). There was an inverse association between basal skeletal muscle mass index and the risk of diabetes in participants with impaired glucose regulation but not in those with normal glucose tolerance. Multivariate-adjusted hazard ratios for the risk of developing diabetes were 0.85 (95% CI: 0.74–0.98) and 1.15 (95% CI: 0.98–1.34), respectively. Furthermore, Cox regression analysis revealed that a two-year change in skeletal muscle mass was also inversely associated with the incidence of diabetes in both participants with normal glucose tolerance and with impaired glucose regulation (HR: 0.76, 95% CI: 0.65–0.89; HR: 0.81, 95% CI: 0.71–0.91). Conclusions: These findings emphasized the importance of early detection and control of muscle mass loss for the prevention of diabetes. [ABSTRACT FROM AUTHOR]

Glucose monitoring is an important component of diabetes management. The Chinese Diabetes Society (CDS) has been producing evidence‐based guidelines on the optimal use of glucose monitoring since 2011. In recent years, new technologies in glucose monitoring and more clinical evidence, especially those derived from Chinese populations, have emerged. In this context, the CDS organised experts to revise the Clinical application guidelines for blood glucose monitoring in China in 2021. In this guideline, we focus on four methods of glucose monitoring that are commonly used in clinical practice, including capillary glucose monitoring, glycated haemoglobin A1c, glycated albumin, and continuous glucose monitoring. We describe the definitions and technical characteristics of these methods, the factor that may interfere with the measurement, the advantages and caveats in clinical practice, the interpretation of glucose metrics, and the relevant supporting evidence. The recommendations for the use of these methods are also provided. The various methods of glucose monitoring have their strengths and limitations and cannot be replaced by one another. We hope that these guidelines could aid in the optimal application of common methods of glucose monitoring in clinical practice for better diabetes care. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between disposition index (DI) and the risk of adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM). Methods A total of 1 912 women were prospectively recruited from January 2015 to December 2017 in Department of Gynecology and Obstetrics of the Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital. According to whether they had GDM, they were divided into GDM group (434 cases) and non-GDM group (1 478 cases). All participants received a 75 g oral glucose tolerance test (OGTT) during the 24-28 gestational weeks and complete basal and delivery information was collected. The insulin sensitivity index (ISI) and the area under the insulin curve/area under the blood glucose curve (AUCINS120/AUCGLU120) were calculated from the results of the 75 g OGTT. The DI was calculated as the product of the ISI and AUCINS120/AUCGLU120 and then log transformed. Adverse pregnancy outcomes were defined as large for gestational age (LGA), primary cesarean section, preeclampsia, and preterm birth. Comparison between groups was performed by t test, Wilcoxon rank sum test and χ² test. Logistic regression analysis was used to explore the relationship between DI and the risk of adverse pregnancy outcomes. Results Women with GDM had a lower ISI even DI than women without GDM. Compared with women with GDM in the lowest quartile (Q1, DI<2.90) of DI, multivariable adjusted (age, body mass index, other pregnancy complications, gestational age at the time of OGTT, fetal sex and parity) odds ratios (OR) of adverse pregnancy outcomes of those in the second (Q2, DI 2.90-3.02), third (Q3, DI 3.03-3.16), and highest (Q4, DI>3.16) quartiles of DI were reduced by 55% (95%CI 0.23-0.87), 34% (95%CI 0.35-1.25), and 59% (95%CI 0.24-0.71) (P for trend=0.01), respectively. When DI was considered as a continuous variable, the multivariable adjusted OR of adverse pregnancy outcomes in women with GDM was reduced by 60% (95%CI 0.21-0.73) for each one unit increase in DI. However, DI was not associated with adverse pregnancy outcomes in women without GDM (OR=0.66, 95%CI 0.36-1.18). Conclusion Elevated DI levels in women with GDM are closely associated with a reduced risk of adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

We investigated the real-world incidence of hypoglycemic events among patients with type 1 or type 2 diabetes (T1DM or T2DM) receiving insulin in routine clinical practice in China. In this observational study, data were collected electronically via the Lilly Connected Care Program (LCCP) electronic system from adults with T1DM or T2DM who had registered on LCCP between 1 February 2019 and 31 January 2022, had used insulin for a full 12-week period following registration. The following outcomes were assessed during the 12 weeks following registration: incidence of level 1 and level 2 hypoglycemia. In total, 22,752 patients were enrolled. Among patients with monitoring data, over the 12-week study period, level 1 and 2 hypoglycemia were experienced by 48.8% and 25.9% of patients with T1DM and 26.5% and 13.9% of patients with T2DM. The proportion of patients treated with oral anti-diabetes drugs (OADs) capable of producing hypoglycemia (sulfonylurea or glinide) was 1.3% in T1DM and 1.6% in T2DM, respectively. Questionnaire data revealed that up to 92.5% of hypoglycemic events occurred outside of hospital and 18.6% were serious. These real-world data collected from Chinese patients with diabetes receiving insulin treatment reveal a relatively high percentage of patients experiencing hypoglycemia, with around one quarter of these events classified as severe and as many as 92.5% occurring outside of a hospital or clinic. [ABSTRACT FROM AUTHOR]

Aims: We assessed the impact of changes in body mass index (BMI), body fat percentage (BF%), and waist circumference (WC) on prediabetes among Chinese middle-aged and elderly adults.Subjects, Materials and Methods: 2.5-year changes in BMI, BF%, and WC were calculated by subtracting baseline levels from follow-up, based on a cohort of 3,632 participants with prediabetes, and outcomes were defined as remission to normal glucose regulation (NGR), persistence in prediabetes, and progression to newly diagnosed diabetes mellitus (NDM).Results: Among participants with prediabetes, 16.9% returned to NGR and 24.6% progressed to NDM. Changes in BMI, BF%, but not WC were associated with remission and progression of prediabetes (risk ratio per standard deviation increase of BMI: 0.86 [0.79-0.93] and 1.15 [1.08-1.23]; BF%: 0.91 [0.84-0.98] and 1.11 [1.03-1.19]). Among participants with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), only BF% change was significantly associated with remission of prediabetes.Conclusion: Short-term management of BMI and BF% should be stressed to promote the remission and prevent the progression of prediabetes, regardless of whether someone is obese. Moreover, it is of particular clinical importance to monitor BF% among people with combined IFG and IGT. [ABSTRACT FROM AUTHOR]