ObjectiveTo analyze the prevalence of potentially inappropriate medication use in older adults and develop a nomogram for predicting the individualized risk for potentially inappropriate medication use.MethodsA retrospective cross-sectional study was conducted using prescription data from older adults who visited the Hefei Third People's Hospital between May 2022 and May 2024. The 2019 Beers Criteria and Chinese criteria for Determining Potentially Inappropriate Medication Use in Older Adults in China were used to identify potentially inappropriate medication use. We conducted univariate and multivariate logistic regression analyses to identify the factors associated with potentially inappropriate medication use and developed a nomogram model to predict the individualized risk of potentially inappropriate medication use.ResultsAmong the 475 older adults included, 195 (41.05%) had at least one incidence of potentially inappropriate medication use (total 288 occurrences). Medications considered as potentially inappropriate were most commonly used (88.72%), followed by medications to be used with caution (6.67%), potentially inappropriate drug-drug interactions (1.54%), and medications potentially inappropriate for patients with certain diseases or syndromes (2.05%). Benzodiazepines, rapid/short-acting insulin, proton pump inhibitors, and amitriptyline were the most frequently used potentially inappropriate medications. Independent risk factors for potentially inappropriate medication use included: (a) age ≥70 years; (b) diabetes mellitus; (c) hypertension; (d) coronary heart disease; (e) sleep disorders; (f) ≥3 comorbidities; and (g) use of ≥4 medications. The nomogram showed moderate discriminative ability (concordance index =0.738) with good calibration and minimal overfitting.ConclusionAdvanced age, multiple chronic conditions, and polypharmacy are key predictors of potentially inappropriate medication in older adults. Enhanced monitoring and personalized medication management may help reduce the risk of potentially inappropriate medication use in this population.

Electronic devices are increasingly used to support self-management in adults with type 1 diabetes (T1DM). However, understanding patient perceptions and lived experiences is essential to ensure effectiveness, equitable accessibility, and sustained acceptance. This qualitative evidence synthesis explored how adults with T1DM perceive and experience electronic devices for self-management, focusing on benefits, barriers, and contextual factors influencing use. A systematic search across six databases was conducted using the Cochrane Qualitative and Implementation Methods Group approach. Qualitative studies published up to December 2024 were included. Data were analyzed using descriptive thematic synthesis and reported, following PRISMA and ENTREQ guidelines. Twenty-seven studies encompassing 522 participants were included. Eight key review findings emerged: Digital devices foster empowerment, encourage positive lifestyle changes, and could improve interactions with healthcare professionals. However, sustained use and engagement were shaped by contextual and emotional factors. Significant barriers include financial constraints, technical and usability problems, and limited continuous psychological and clinical support. Social support and integration into healthcare systems also influenced engagement. Electronic devices for T1DM self-management are complex socio-technical interventions whose potential depends on truly person-centered, equitable, supportive care. Trial Registration: PROSPERO: CRD42024572860.

This study aimed to assess the prevalence of diabetes and associated risk factors and to deepen understanding of the diabetes burden in Ga Mashie, an urban-poor area in Accra, Ghana.

Cross-sectional epidemiological cluster survey.

We surveyed adults aged over 25 years in 80 enumeration areas within Ga Mashie, targeting 959 randomly selected households based on the 2021 census.

Household-level data included household membership and structure, water and sanitation, cooking infrastructure and asset ownership. Individual-level data encompassed demographics, lifestyle behaviours and biometric measurements. Diabetes was identified through random blood glucose levels ≥11.1 mmol/L or a prior diagnosis, with obesity defined as a body mass index >30 kg/m² and central obesity as a waist circumference-to-height ratio >0.5. We derived weighted prevalence estimates and compared these estimates by age, sex and wealth using unadjusted ORs.

The survey, achieving a 67% response rate, covered 854 individuals from 644 households. It unveiled a notable prevalence of risk factors known to be associated with diabetes: 47.2% for alcohol consumption (95% CI 43.7% to 50.8%), 50.7% for insufficient physical activity (95% CI 46.0% to 55.3%), 28.9% for unhealthy snack consumption (95% CI 24.5% to 33.7%), 35.1% for obesity (95% CI 31.3% to 39.1%) and 74.5% for central obesity (95% CI 70.8% to 77.9%). Diabetes affected 8.2% of the population aged ≥25 (95% CI 6.4% to 10.5%), with disparities evident across age, wealth and sex (2.66 greater odds in females for diabetes (95% CI 1.38 to 5.12)).

Diabetes and its risk factors are highly prevalent in Ga Mashie, with significant demographic disparities underscoring the need for targeted interventions. The study highlights the critical challenge diabetes poses in urban-poor contexts, emphasising the necessity for tailored health initiatives to mitigate this burden.

To establish the incidence of developing diabetes mellitus (DM) post hospitalisation with influenza.

Retrospective cohort study.

Electronic healthcare records from Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics in England.

13 710 adults with a first episode of hospitalised influenza as the primary cause for admission between 1 July 2004 and 1 March 2021 based on ICD-10 codes without pre-existing DM were included. A randomly selected group (a) from CPRD records matched for age, sex and General Practitioner (GP) practice and (b) an unmatched group of hospitalised sepsis patients were used as comparator groups.

Patients were followed from 1 day after discharge till either DM diagnosis, death or end of GP record. HRs for incidence of DM were calculated using adjusted Cox regression models.

Incidence of DM was 12.5 per 1000 person years. Adjusted HRs (aHR) for developing DM after hospitalised influenza compared with matched controls was 1.54 (95% CI 1.39 to 1.70, p<0.001) and to hospitalised sepsis comparators 1.14 (95% CI 1.03 to 1.26, p=0.013). The greatest risk for developing DM in hospitalised influenza patients was within 90 days of discharge (aHR 2.71 (95% CI 1.94 to 3.77, p<0.001)) compared with matched controls. Risk factors for DM after influenza hospitalisation included being male, pre-existing DM risk, obesity and critical care admission during acute illness.

Patients' post hospitalisation with influenza had a greater incidence of DM when compared with both matched controls and patients following hospitalisation with sepsis.

To examine the associations between social isolation (SI) and mental health, health behaviours and diabetes management among older adults with diabetes in South Korea, focusing on gender-specific syndemic patterns.

Cross-sectional secondary analysis.

2023 Korea Community Health Survey, a nationwide community-based survey.

18 924 adults aged ≥65 years with physician-diagnosed diabetes.

Mental health (depressive symptoms, perceived stress), health behaviours (smoking, high-risk drinking, physical activity) and diabetes management (medication use, complication screening, diabetes education) were assessed. Multivariable logistic regression was used to estimate the adjusted associations between SI and study outcomes.

SI was more prevalent among women (33.6%) than among men (14.1%). In men, SI was associated with depressive symptoms (aOR=1.60, 95% CI 1.18 to 2.18, p=0.003), smoking (aOR=1.51, 95% CI 1.25 to 1.82, p<0.001), high-risk drinking (aOR=1.76, 95% CI 1.36 to 2.28, p<0.001) and lower diabetes education participation (aOR=0.80, 95% CI 0.65 to 0.99, p=0.031). Among women, SI was associated with depressive symptoms (aOR=1.35, 95% CI 1.07 to 1.69, p=0.010), smoking (aOR=2.53, 95% CI 1.69 to 3.78, p<0.001), lower physical activity (aOR=0.56, 95% CI 0.44 to 0.71, p<0.001), lower medication use (aOR=0.51, 95% CI 0.38 to 0.69, p<0.001), reduced complication screening (aOR=0.86, 95% CI 0.76 to 0.97, p=0.016) and lower diabetes education participation (aOR=0.81, 95% CI 0.69 to 0.95, p=0.010). SI was not significantly associated with perceived stress in either gender.

SI was associated with poorer mental health and unhealthy behaviours among older adults with diabetes, with distinct gender-specific patterns. The SI also showed non-uniform associations with diabetes management, indicating that its impact may differ across management domains. Addressing SI may support improvements in selected aspects of diabetes care. Further research should clarify the mechanisms linking SI and disease management.

This study aims at exploring longitudinal trends in the onset of type 2 diabetes in the disadvantaged urban neighbourhood of Tingbjerg before and during implementation of interventions within the Danish health promotion initiative Tingbjerg Changing Diabetes. The findings are compared with trends in the national population.

Using Poisson regression, trends in age-specific incidence rates were estimated in both populations during the full timespan with adjustments for gender and educational attainment. We used anonymised national registers to obtain sociodemographic and health information about all residents in Tingbjerg. Likewise, information from the remaining national population was analysed for comparison.

Tingbjerg is a disadvantaged neighbourhood with approximately 7000 residents located in the outskirts of Copenhagen.

The full national adult population in Denmark, from 2003 to the end of 2022, was included in the study.

Tingbjerg Changing Diabetes is a long-term complex community-based health promotion initiative that started in 2015 and aims at enhancing well-being, promoting healthy living and preventing type 2 diabetes and other chronic diseases among residents of the local community.

The outcome measure was onset of type 2 diabetes assessed by clinical register data.

Estimated trends show relatively higher age-adjusted incidence rates of type 2 diabetes in Tingbjerg compared with the national population with an almost two-fold higher rate in Tingbjerg in 2015. From 2015, a decline in the incidence rate was observed in Tingbjerg whereas an increase was observed in the national population, resulting in almost similar rates in 2022.

Exploration of type 2 diabetes incidence rates from 2003 to 2022 shows relative improvements in Tingbjerg after 2015. It is unknown to what extent the interventions have impacted the observed trends.

Nicotinamide mononucleotide (NMN) improves the pathogenesis of age-related changes and diseases by increasing intracellular nicotinamide adenine dinucleotide+. We aimed to evaluate retinal thickness changes after oral NMN administration according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grid.

Before and 24 weeks after the study initiated, 240 × 240 mm macular cube scan optical coherence tomography images were obtained from male patients with type 2 diabetes aged ≥ 65 years with physical frailty; changes in the automatically measured mean retinal thickness within the 9 ETDRS grid regions were compared between groups. Participants were randomly assigned to receive 250 mg/day NMN or placebo orally for 24 weeks. Retinal thickness changes at 24 weeks were compared between groups.

Each group included 14 eyes of 7 patients; 8 eyes had ocular disease. Best-corrected visual acuity did not change significantly between baseline and 24 weeks for both groups. In the temporal subretinal field of the outer circle, the retinal thickness change from baseline to 24 weeks differed significantly between the NMN and placebo groups (+1.14 ± 2.85 μm and -2.77 ± 3.30 μm, respectively; p = 0.006). Among patients without ocular disease, the NMN group demonstrated a trend toward suppressed reduction in retinal thickness in the temporal region (+0.75 ± 3.20 μm and -2.45 ± 3.33 μm in the NMN and placebo groups, respectively; p = 0.07). Systematic and ophthalmic adverse events were not observed in the NMN group.

The oral NMN administration was safe both systemically and locally in the eyes. Based on the retinal thickness results, NMN may be efficacious in mitigating age-related alterations in the retina.

Plant-based diets are increasingly popular and may improve cardiometabolic health, but their association with adverse pregnancy outcomes (APOs) is unclear; and dietary patterns are influenced by food access.

We investigated whether adherence to plant-based dietary patterns were associated with APOs and whether the association varied by neighborhood food access.

This is a secondary analysis using data from the Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be (nuMoM2b) cohort. Diet scores for the newer Healthy Plant-Based Diet Index (hPDI) and more established Dietary Approaches to Stop Hypertension (DASH) were derived from first-trimester Block Food Frequency Questionnaires and assessed in tertiles (T1= "low", T3= "high"). APOs included hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth (PTB), small-for-gestational-age (SGA), large-for-gestational-age (LGA), and stillbirth. Modified Poisson regression models were used, adjusting for age, income, education, and health insurance.

Among 7,981 nulliparous individuals, higher hPDI scores were associated with lower risk of HDP (T3 vs. T1: aRR: 0.77; 95% CI: 0.64 to 0.92; T2 vs. T1 aRR: 0.82; 95% CI: 0.70 to 0.97) and GDM (T3 vs. T1: aRR: 0.55; 95% CI: 0.39 to 0.76; T2 vs. T1: aRR: 0.71; 95% CI: 0.54 to 0.95). Higher DASH scores were associated with lower risk of HDP (T3 vs. T1: aRR 0.83; 95% CI: 0.70 to 0.98); and GDM, albeit for the second tertile only (T2 vs. T1: aRR 0.69; 95% CI 0.52 to 0.90). Neither diet was associated with PTB, SGA, or LGA. The frequency of low food access decreased across tertiles for both the hPDI and DASH (p<0.05), but the associations between diet and APOs did not vary by food access (p>.05).

A healthy plant-based diet in early pregnancy was associated with a lower risk of developing HDP and GDM in nulliparous individuals, which was similar with a DASH diet.

Metformin, widely used for type 2 diabetes mellitus, has demonstrated antitumor effects through modulation of metabolic and immune pathways. This review explores its potential role in the prevention and treatment of skin cancers, including melanoma and nonmelanoma skin cancers (NMSCs).

A structured PubMed search was conducted in April 2025 to identify English-language, peer-reviewed original research articles evaluating the effects of metformin on melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Experimental, observational, and clinical studies were included; reviews and meta-analyses were excluded.

Twenty studies met the inclusion criteria. In melanoma models, metformin inhibited tumor proliferation, suppressed epithelial-mesenchymal transition, and enhanced immune responses. Observational studies reported improved recurrence-free survival and treatment outcomes, although findings were inconsistent. In NMSC studies, metformin use was associated with reduced incidence of BCC and SCC. Preclinical models demonstrated delayed tumor development and an enhanced response to photodynamic therapy following metformin treatment.

Mechanistic and preclinical data support a biologically plausible role for metformin in skin cancer prevention and therapy. Evidence is strongest for BCC, particularly in enhancing photodynamic therapy and reducing incidence in at-risk populations. Melanoma studies suggest synergy with immunotherapy, but clinical results remain variable.

Metformin shows promise as a low-cost, well-tolerated adjunctive therapy in dermatologic oncology. Further prospective and controlled studies are needed to clarify its efficacy, optimize dosing, and identify populations most likely to benefit.

Diabetes mellitus (DM) is a significant driver of excess morbidity and premature mortality, though few contemporary or locally-derived data quantify this impact on New Zealanders, particularly Māori and Pacific Peoples. This prospective, national population study examines the life expectancy (LE) for New Zealanders with and without DM, and characterises mortality rates.

Data from 01/01/2015 to 31/12/2019 housed in the Integrated Data Infrastructure, including the Virtual Diabetes Registry and Health New Zealand Mortality Collection, were linked. Estimated remaining LE years were calculated using abridged period life tables using the Chiang method for those with type 1 diabetes (T1D), type 2 diabetes (T2D), and without DM. Sub-group analysis by ethnicity was completed. Five-year cause-specific mortality rates per 100,000 people were compared by DM group.

T1D and T2D prevalence was 0.4% and 5.5% in the overall sample (n = 4,505,478). Considerable ethnic differences in LE were evident, for example a 13-, 17.1-, and 24.5-year loss in remaining LE years was seen in men aged 0-19 years with T1D in the overall, Māori, and Pacific Peoples groups respectively compared to those without DM. An age-dependent reduction in remaining life expectancy years was also evident; for example an 8.6 (8.5-8.7) year reduction seen in females with DM aged 0-4, and 4.0 (4.0-4.1) year reduction for women with DM aged 65-69. Those with DM had higher cause-specific death rates.

DM is associated with age-dependent reductions in LE across the entire lifespan, with disproportionately higher LE loss seen in Māori and Pacific Peoples.