Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated cardiovascular benefit in patients with type 2 diabetes mellitus (T2DM) and established atherosclerotic disease. Its role in the immediate postacute coronary syndrome (ACS) setting, however, remains unexplored. This study evaluated the early real-world use of semaglutide prescribed at hospital discharge after ACS.

We conducted a retrospective, multicenter observational study of adults with T2DM hospitalized for ACS between January 2022 and December 2024 and discharged with a prescription for semaglutide. Baseline demographics, therapies, and ACS features were collected together with follow-up data on treatment persistence, reasons for discontinuation, adverse events, metabolic parameters, and cardiovascular outcomes.

A total of 60 patients (mean age 61.1 ± 10.8 years, 73% male) were included. At discharge, all received semaglutide (83.3% injectable, 16.7% oral) at the lowest dose. At the first follow-up (108 ± 39 days), 81% remained on therapy; discontinuations occurred mainly for gastrointestinal intolerance (15%). Body weight decreased by 4.7 ± 1.6 kg, BMI decreased by 1.7 ± 0.6 kg/m2, and HbA1c improved from 64.3 ± 18.2 to 49.6 ± 10.4 mmol/mol. At the second follow-up (278 ± 60 days, n = 39), 97.4% were still on semaglutide. Additional weight loss (-2.6 ± 3.8 kg) and further HbA1c reduction (40.5 ± 18.6 mmol/mol) were observed. No cardiovascular events, renal decline, or pancreatic events were reported.

In this exploratory real-world cohort, initiating semaglutide at hospital discharge after ACS was feasible, well tolerated, and associated with high persistence and early cardiometabolic improvements.

Studies have shown that temperature is closely related to human metabolism, but only a few studies have focused on the effect of abmient temperature on gestational diabetes mellitus (GDM). Evidence from temperate regions is particularly lacking. Our study aimed to explore the association between ambient temperature during pregnancy and the risk of GDM, and further analyze the critical window. This study used data from the Shandong Multi-Center Healthcare Big Data Platform (SMCHBDP). Generalized additive model (GAM) and logistic regression were used to analyze the association between ambient temperature and the risk of GDM. Distributed lag non-linear models (DLNMs) were applied to assess the critical window. Among 3052 subjects, 382 pregnant women were diagnosed with GDM (12.52%). GAM and logistic regression showed that high mean temperature (> 25.18℃) during the 2nd trimester was the risk factor for GDM, and the aOR (95%CI) was 1.67 (1.15-2.45). Extreme high temperature during 13th-18th weeks of gestation was associated with an increased risk of GDM. The effect was greatest at the 16th week of gestation, and the ORs for maximum temperature, minimum temperature and mean temperature were 2.15 (1.19-3.89), 2.25 (1.27-4.01) and 2.71 (1.43-5.13), respectively. An increased risk of GDM was observed for each IQR (2.2 °C) increase in diurnal temperature range (DTR) at 17th-21st weeks of gestation. Therefore, extreme high temperature and DTR affect GDM mainly in the 2nd trimester. These findings highlight the need for targeted protective measures for pregnant women during these periods, especially amid global warming, to mitigate temperature-related GDM risk.

Medication adherence is vital for older adults living with type 2 diabetes mellitus (T2DM), but it remains low and needs improvement. Current interventions have limited effectiveness, while video-based interventions show promising potential for enhancing adherence.

To evaluate the impact of the "Diabetes Little Helper" video intervention, developed based on the information-motivation-behavioral skills model, on improving medication adherence in older adults living with T2DM in Henan.

This parallel-group randomized controlled trial was conducted in 2 hospitals in Zhengzhou, involving 68 patients from each hospital. The intervention group (IG) received standard care plus the video intervention for one month, while the control group (CG) received only standard care. The primary outcome was medication adherence, and secondary outcomes included medication knowledge, attitude, behavior, belief, and social support. Data were collected at baseline, postintervention, and at 3-month follow-up. Intention-to-treat analysis and the last observation carried forward method were applied for missing data, with the generalized estimating equation model used for effect assessment (P<.05 considered statistically significant).

The average age of participants in the IG was 67.5 (SD 8.0) years, while in the CG, the average age was 66.0 (SD 7.0) years. Sex distribution was nearly identical, with 51.5% (n=35) of participants in the IG and 50.0% (n=34) in the CG being male. After the intervention, the IG and CG had retention rates of 95.6% (n=65) and 97.1% (n=66), respectively. At the 3-month follow-up, the retention rates for the IG and CG were 92.6% (n=63) and 92.2% (n=62), respectively. Both postintervention (β=4.956, 95% CI 3.702-6.210, P<.001) and at the 3-month follow-up (β=3.691, 95% CI 2.379-5.003, P<.001), medication adherence score for the IG was significantly higher than that for the CG. In addition, the IG showed significant improvements in secondary outcome, with medication knowledge (β=11.592, 95% CI 6.923-16.260, P<.001), attitude (β=5.467, 95% CI 4.531-6.763, P<.001), behavior (β=4.176, 95% CI 3.220-5.133, P<.001), and belief (β=2.882, 95% CI 1.990-3.775, P<.001) compared with the CG postintervention. However, there was no statistically significant difference in the secondary outcome of social support (β=0.008, 95% CI -1.834 to 2.011, P=.928).

The Diabetes Little Helper video intervention effectively improved medication adherence in older adults living with T2DM in Henan, highlighting the potential of digital health tools for managing chronic diseases in older adult populations.

Chinese Clinical Trial Registry ChiCTR2400083282; https://www.chictr.org.cn/showprojEN.html?proj=214847.

The CamAPS FX automated insulin delivery (AID) system is extensively evaluated and uniquely tailored for T1D pregnancies. This study evaluated the clinical and economic implications of improving glycemia with CamAPS FX AID compared with the current standard of care (SoC).

A cost-consequence model was built leveraging data from the AiDAPT study and was adapted to the Spanish health care perspective, using local costs obtained from the literature or hospital databases. As observed in AiDAPT, women treated with AID began with an average glycated hemoglobin (HbA1c) of 7.6% (±1.1) and reached a post-treatment average of 6.0% (±0.5), demonstrating significant improvement in glycemic control. However, in the model, clinical outcomes and the resulting cost impact are based on the incremental 0.3% HbA1c reduction from the first to the third trimester using AID over SoC treatment.

Using CamAPS FX AID instead of SoC in pregnancies complicated by T1D resulted in estimated cost savings of €1,002 per treated woman for the Spanish health care system within the first year of treatment. Of these cost savings, the majority (81%) were driven by reductions in intensive neonatal care admissions, reflecting not only marked financial savings but, more importantly, a reduction in complications and suffering among newborns.

This conservative analysis captures a clinically significant impact and subsequent economic value, despite being based on only a limited number of perinatal complications. This study provides valuable insights to guide clinical practice, shape health care decision-making, and support broader adoption of technologies that improve maternal and neonatal outcomes.

To characterize and predict otolith dysfunction of the peripheral vestibular system and its effect on balance in people with diabetes mellitus (DM).

This cross-sectional study included people with DM and peripheral neuropathy (PN), DM without PN, and controls (N = 68). Participant characteristics (e.g., age, HbA1c) including clinical measures of PN were procured. Cervical (saccule pathway) and ocular (utricle pathway) vestibular evoked myogenic potential (VEMP) testing outcomes included interamplitude and absent response counts. The Functional Gait Assessment and activity watch step counts characterized participant function. VEMP outcomes were compared between groups. In all DM participants, logistic regression was used to predict VEMP responses from participant characteristics, and functional outcomes were compared between those with and without VEMP responses.

Worse PN predicted abnormal utricle and saccule function (1.1 ≤ odds ratio ≤ 1.7, p ≤ 0.05). Utricle function was the worst (p ≤ 0.04) and more frequently absent in those with DMPN. Balance and physical activity were worse in those with absent utricle (p ≤ 0.03), but not saccule, responses.

Clinical measures of PN can provide rationale for vestibular testing as those with DM and abnormal utricle function have imbalance and low physical activity.

Hypertension is a leading modifiable risk factor for cardiovascular disease and premature death among adults. Up to 18% of individuals with hypertension have resistant hypertension (rHTN), which substantially increases the risk of adverse clinical outcomes. Endogenous hypercortisolism can result in rHTN through multiple mechanisms.

MOMENTUM (NCT06829537) is the first large, observational, multicenter study examining the prevalence of endogenous hypercortisolism among adults with rHTN in the United States.

Target enrollment is approximately 1,000 participants. To be eligible, adults aged ≥18 years must have rHTN, defined using the American Heart Association criteria (systolic blood pressure ≥130 mm Hg despite ≥3 antihypertensive medications of different classes at maximally tolerated doses, including a diuretic, or ≥4 medications from different classes regardless of systolic blood pressure). Endogenous hypercortisolism is defined as cortisol level >1.8 μg/dL on the 1-mg overnight dexamethasone suppression test with adequate dexamethasone (≥140 ng/dL). The primary endpoint is endogenous hypercortisolism prevalence.

MOMENTUM will provide new insight into endogenous hypercortisolism in patients with resistant hypertension.

Diabetic cardiomyopathy (DbCM), a severe complication of type 2 diabetes mellitus (T2DM), is pathologically characterized by myocardial lipid deposition leading to cardiomyocyte lipotoxic injury. Annexin A3 (ANXA3), a lipid storage inhibitory protein highly expressed in cardiomyocytes, shows altered expression in T2DM tissues, yet its regulatory role in myocardial lipid deposition remains unclear. Enhanced nitrosative stress in T2DM cardiomyocytes induces abnormal protein nitration, and while anti-nitration therapy demonstrates cardioprotective effects, the nitration-mediated regulation of ANXA3 expression requires elucidation. This study investigates ANXA3's regulatory function in T2DM-induced lipid deposition and explores nitration-mediated mechanisms underlying ANXA3 dysregulated expression.

The T2DM mouse model was established using db/db mice to investigate the pathological mechanisms of DbCM. ANXA3 was overexpressed via cardiac-specific adeno-associated virus delivery to assess its role in lipid deposition. Peroxynitrite scavengers were administered to evaluate lipid droplet accumulation reversal. Site-directed mutagenesis plasmids identified tyrosine residues undergoing nitration.

1) Lipid deposition in the myocardial tissue of DbCM mice is related to downregulation of ANXA3 expression. ANXA3 regulates lipid droplet degradation in DbCM myocardial tissue though regulation of the microlipophagy-Rab7a pathway; 2) The transcription of ANXA3 gene was regulated positively by YY1; 3) In the pathological environment of T2DM, the ability of YY1 to transcribe the ANXA3 gene was decreased, which was related to its nitration at the Y¹⁸⁵ site of YY1 protein.

T2DM promoted cardiomyocyte YY1 nitration at Y¹⁸⁵ and Y³⁸³ residues. Y¹⁸⁵ site nitration inhibited YY1 nuclear translocation, thereby attenuating ANXA3 transcription. Microlipophagy emerged as the principal lipid droplet degradation mechanism in diabetic cardiomyocytes. ANXA3 downregulation suppresses Rab7a expression, impairing microlipophagy and causing lipid deposition that exacerbates DbCM progression. Therapeutic strategies targeting YY1 nitration inhibition or enhancing ANXA3-mediated microlipophagy demonstrate therapeutic potential for mitigating.

Periodontitis (PD) and type 2 diabetes mellitus (DM) are bidirectionally associated through shared chronic inflammatory mechanisms. Although monocytes serve as central immune mediators in both pathologies, their functional heterogeneity and dynamic alterations in diabetic periodontitis (PDDM) remain poorly characterized. Utilizing single-cell RNA sequencing (scRNA-seq) of peripheral blood mononuclear cells (PBMCs) from healthy controls, PD patients, and PDDM subjects, we systematically investigated the immunopathological crosstalk between these comorbidities. Our analysis revealed a significant shift in monocyte subpopulations, with PDDM patients exhibiting increased classical monocytes (CD14++CD16-) and decreased nonclassical monocytes (CD14 + CD16++) compared to PD counterparts. Functional profiling demonstrated PDDM-enriched classical monocytes upregulated oxygen transport pathways while suppressing chemotaxis and cytokine responses, whereas nonclassical monocytes showed impaired oxidative phosphorylation and nucleotide biosynthesis. Cell communication analysis identified reduced activity of TGF-β signaling and enhanced CCL pathway activation, collectively promoting chronic inflammation and tissue destruction. Regulatory network reconstruction revealed transcription factors (PBX1, TAL1, IRF9) governing monocyte differentiation defects and hyperinflammatory phenotypes. These results suggest mechanistic links how diabetic conditions exacerbate periodontal inflammation through monocyte reprogramming and signaling pathway dysregulation, providing a cellular roadmap for developing targeted immunotherapies in PDDM management.