Volume 18 · Issue 05 · 2026

A recently published 24-week, prospective, single-arm, open-label interventional subpopulation analysis of the INITIATION study enrolled 302 Chinese adults with type 2 diabetes mellitus (T2DM) who had inadequate glycemic control and were switched to insulin glargine 300 U/ml (Gla-300) from other basal insulin (BI) therapy. At week 24, mean glycated hemoglobin (HbA_1c) was reduced by 0.87%, with consistent trends in subgroups switched from insulin glargine 100 U/ml (Gla-100) or insulin degludec. Fasting plasma glucose (FPG) was reduced by 1.13 mmol/L. Hypoglycemic events were predominantly mild, with a low incidence of documented symptomatic hypoglycemia (<3.0 mmol/L) at 4.7% (14/299). Minimal body weight change was documented. The total Diabetes Treatment Satisfaction Questionnaire (DTSQ) score increased from 30.4 at baseline to 33.1 at week 24 (P<0.001). In conclusion, switching to Gla-300 achieved further glycemic improvement with predominantly mild hypoglycemia and enhanced treatment satisfaction in Chinese adults with T2DM with inadequate glycemic control on prior basal insulin therapy.

In 2025, the American Diabetes Association (ADA) issued a consensus report on "Screening and Early Intervention for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Patients with Diabetes." This article provides an interpretation of the consensus, focusing on four key dimensions: the evolution of MASLD nomenclature and regional differences, key points of the consensus, discrepancies between Chinese and international guidelines, and future research directions. Differences between Chinese and international consensus exist in terms of terminology, screening cut-off points, and treatment recommendations. In clinical practice, integrating both Chinese and international guidelines is essential to promote the implementation of a combined diabetes-liver disease management model and to improve patient outcomes.

Recent studies have deepened our understanding of the regulatory and injury mechanisms of pancreatic β-cell function. Moreover, traditional assessment tools have been reappraised, and novel evaluation methods have been developed. These advances have greatly expanded the therapeutic landscape. Meanwhile, the diversification of weight management strategies and the emergence of innovative pharmacotherapies have provided clinicians with unprecedented opportunities for accurate assessment and effective preservation of β-cell function. In response to these developments, the Pancreatic Islet β-Cell Expert Panel of the Chinese Diabetes Society, in collaboration with the Endocrinology Branch of the Jiangsu Medical Association, convened a multidisciplinary panel to update the consensus originally published in 2022, following multiple rounds of rigorous expert deliberation and revision. This updated version emphasizes: (1) assessment of β-cell function using both static and dynamic methods; (2) optimization of weight management, achievement of early and sustained near-normoglycemic control, and improvement of the islet microenvironment as fundamental to β-cell protection; and (3) minimization of the use of drugs potentially harmful to β-cells within clinical constraints. This consensus aims to provide more targeted, evidence-based, and practical guidance for clinical practice.

To investigate the genotypic characteristics of human leukocyte antigen (HLA) class Ⅰ and class Ⅱ in patients with immune checkpoint inhibitor-associated diabetes mellitus (ICI-DM).

This cross-sectional study consecutively enrolled 38 patients with newly diagnosed ICI-DM and 93 patients with type 1 diabetes mellitus (T1DM) from the Department of Endocrinology at Xiangya Third Hospital, Central South University, between January 2022 and April 2025. Demographic data including age and sex were collected. HLA class Ⅰ and class Ⅱ genotyping was conducted using next-generation sequencing (NGS) technology. Intergroup comparisons were conducted using the independent-samples t-test, Mann-Whitney U test, chi-square test, or Fisher′s exact test, with corrections for multiple comparisons and present the corrected P-value (Pc).

Compared with T1DM patients, ICI-DM patients were older [(34.90±15.14) vs. (57.83±9.92) years, t=8.85, P<0.001] and had a higher proportion of males [56.99% (53/93) vs. 76.32% (29/38), χ²=4.30, P=0.038]. Compared with T1DM patients, ICI-DM patients had a lower frequency of the T1DM-susceptible DRB1*0301-DQA1*05-DQB1*0201 haplotype [12.90% (24/186) vs. 2.63% (2/76), Pc=0.060], while the frequencies of the protective DRB1*1101-DQA1*05-DQB1*0301 [1.61% (3/186) vs. 9.21% (7/76), Pc=0.060] and DRB1*1202-DQA1*0601-DQB1*0301 [5.91% (11/186) vs. 14.47% (11/76), Pc=0.077]. Compared with T1DM patients, ICI-DM patients had higher frequencies of HLA-A*26:01 [0 vs.8.33% (4/48), Pc=0.072], HLA-B*46:01 [11.61% (13/112) vs. 31.25% (15/48), Pc=0.039], HLA-B*55:02 [2.68% (3/112) vs. 12.50% (6/48), Pc=0.093], HLA-C*01:02 [16.96% (19/112) vs. 31.25% (15/48), Pc=0.093], while HLA-A*24:02 [27.68% (31/112) vs. 12.50% (6/48), Pc=0.093], and HLA-B*40:01 [24.11% (27/112) vs. 8.33% (4/48), Pc=0.091] showed decreased allele frequencies.

ICI-DM exhibits HLA class Ⅰ and class Ⅱ genotypic profiles distinct from those of classical T1DM. Patients with ICI-DM carry classic T1DM susceptibility haplotypes at a lower frequency and protective haplotypes at a higher frequency.

To explore the impact of the diagnostic cut-off point for hypertension on the 10-year risk of cardiovascular diseases (CVD) in adults aged 40 years and older with different glucose metabolism statuses in the urban area of Guiyang, Guizhou Province.

This was a retrospective cohort study. The subjects were selected from the population aged 40 and above in the urban area of Guiyang who had no cardiovascular disease at the baseline and were included in the "Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION)" conducted from May to August 2011. The subjects were divided into four groups based on the hypertension diagnosis cut-off points of 130/80 mmHg and 140/90 mmHg (1 mmHg=0.133 kPa): the group with blood pressure (BP)≥130/80 mmHg, the group with BP<130/80 mmHg, the group with BP≥140/90 mmHg, and the group with BP<140/90 mmHg. According to the WHO diagnostic criteria, the subjects were classified into the normal blood glucose group, the prediabetes group, and the diabetes group. The subjects were followed up for the outcome of CVD. The effects of different hypertension diagnosis cut-off points on the 10-year CVD risk of different glucose metabolism in people aged 40 and above were analyzed using the multivariate Cox regression analysis method.

A total of 6 893 subjects were included in the study. Among them, 3 163 were in the normal blood glucose group, 2 344 were in the prediabetes group, and 1 386 were in the diabetes group. The results of the two blood pressure diagnostic cut-off points on the occurrence of CVD in different glucose metabolism populations showed that the average follow-up time (10.07±1.49) years for patients with BP≥140/90 mmHg and BP≥130/80 mmHg in the normal blood glucose group, prediabetes group, and diabetes group, respectively, had CVD incidence rates of 9.99% (71/771), 7.62% (87/1 141), 11.12% (97/872), and 9.29% (121/1 303), and 14.19% (103/726) and 12.73% (119/935). In different glucose metabolism populations, compared with using BP 130/80 mmHg as the cut-off point, using BP 140/90 mmHg as the cut-off point showed a stronger association with the 10-year CVD risk (all P<0.05). After adjusting for multiple confounding factors, the multivariate Cox regression analysis showed that when using 140/90 mmHg as the hypertension diagnostic cut-off point, the HR values (95%CI) of 10-year CVD risk for the 40-year-old and above population in the normal blood glucose group, prediabetes group, and diabetes group were 1.863 (1.173-2.958), 1.215 (0.736-2.008), and 1.898 (1.155-3.121), respectively. When using patients with BP 130/80 mmHg as the hypertension diagnostic cut-off point, the HR values (95%CI) of 10-year CVD risk for the 40-year-old and above population in the normal blood glucose group, prediabetes group, and diabetes group were 1.048 (0.716-1.533), 1.068 (0.719-1.587), and 1.685 (1.028-2.762), respectively.

In adults aged 40 years and older with normal glucose metabolism and those with diabetes mellitus in the urban area of Guiyang city, the cut-off point of blood pressure at 140/90 mmHg for diagnosing hypertension may better predict the 10-year risk of cardiovascular diseases.

To investigate the predictive value of the cholesterol-high density lipoprotein-glucose (CHG) index for incident diabetes in adults aged ≥60 years.

This was a retrospective cohort study. Participants aged ≥60 years without diabetes mellitus at baseline who underwent annual physical examination from January 2018 to December 2023 in communities of Kunshan City, Jiangsu Province, were enrolled. Baseline age, sex, fasting plasma glucose (FPG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were collected, and the CHG index was calculated. Participants were followed up at least every 3 months, with incident diabetes mellitus as the endpoint. According to baseline CHG index, participants were divided into quartile groups: Q₁ (2.32-4.93), Q₂ (4.94-5.14), Q₃ (5.15-5.34), and Q₄ (5.35-7.44). Cox regression analysis was performed to examine the association between CHG index and incident diabetes mellitus. Survival curves were plotted using the Kaplan-Meier method and compared with the log-rank test. Restricted cubic spline (RCS) analysis was performed to explore the nonlinear relationship between CHG index and diabetes risk. Stratified and interaction analyses were also conducted.

A total of 7 675 nondiabetic participants aged ≥60 years were finally included, with a mean age of (66.94±4.48) years, including 3 700 males and 3 975 females. After a median follow-up of 3.88 years, 780 participants developed diabetes mellitus. The cumulative incidence rates were 5.11% (98/1 919) in Q₁, 6.69% (128/1 914) in Q₂, 9.88% (190/1 923) in Q₃, and 18.97% (364/1919) in Q₄, with significant differences among the four groups (log-rank P<0.001). After adjustment for multiple covariates, Cox regression showed that compared with Q₁, the risk of diabetes was increased by 17% (HR=1.17, 95%CI 0.90-1.53), 60% (HR=1.60, 95%CI 1.24-2.05), and 158% (HR=2.58, 95%CI 2.02-3.30) in Q₂, Q₃, and Q₄, respectively. A rising trend of diabetes risk with increasing CHG index was observed (P for trend<0.05). The RCS analysis results indicated that there was a non-linear association between the CHG index and the risk of diabetes in the population aged 60 years and above. The overall trend was J-shaped (non-linear test P<0.001). The inflection point (threshold) for the total population was approximately 4.92, above which the risk increased more rapidly with the increase in CHG. Subgroup analysis identified significant interactions with age (P=0.029) and baseline FPG (P=0.023). The association between elevated CHG index and diabetes risk was stronger among participants aged 60-69 years (HR=4.40, 95%CI 3.17-6.08) and those with baseline FPG<6.1 mmol/L (HR=2.12, 95%CI 1.45-3.12).

The CHG index is positively associated with incident diabetes mellitus in adults aged ≥60 years and has predictive value for diabetes risk in this population.

To comprehensively assess glycemic variability using multiple indicators and explore its predictive value for recurrent stroke in diabetic patients with acute ischemic stroke.

This retrospective cohort study enrolled 212 diabetic patients with acute ischemic stroke admitted to The PLA Rocket Force Characteristic Medical Center from September 2022 to July 2025. Clinical data, glycemic variability metrics, and 2-year follow-up outcomes were collected, including age, sex, alcohol history, prior cerebral infarction, diabetes duration, glycated hemoglobin A_1c levels, total protein, low-density lipoprotein cholesterol (LDL-C), and current glucose management regimens. Glycemic variability was evaluated using standard deviation of blood glucose (SDBG), postprandial glucose excursions (PPGE), largest amplitude of glycemic excursion (LAGE) and coefficient of variation (CV). The endpoint event was defined as stroke recurrence during the 2-year follow-up or death within 30 days post-discharge. Logistic regression was used to identify factors associated with endpoint events. Receiver operating characteristic (ROC) curves were used to assess the predictive value of glycemic variability indicators, and a nomogram was constructed to evaluate the contribution of each factor.

A total of 212 patients were enrolled, with an average age of (66.41±11.51) years, including 141 males and 71 females. Eighteen patients (8.5%) experienced endpoint events (event group) during follow-up. Comparison of baseline data between the event group and the non-event group showed that there was no statistically significant difference except for diabetes duration [(16.90±9.79) years vs. (10.83±8.24) years, P<0.05]. Diabetes duration (OR=1.13, 95%CI 1.03-1.24) and LDL-C (OR=2.49, 95%CI 1.09-5.66) were identified as risk factors for endpoint events (both P<0.05). A nomogram prediction model for endpoint events was constructed based on diabetes duration and LDL-C, and internal validation demonstrated satisfactory performance. ROC curve analysis showed that the AUC values for diabetes duration and LDL-C in predicting endpoint events were 0.68 (95%CI 0.49-0.88) and 0.63 (95%CI 0.45-0.81), respectively.

Glycemic variability was not statistically associated with the composite endpoint during follow-up in patients with acute ischemic stroke and diabetes. Diabetes duration and LDL-C were identified as significant risk factors for stroke recurrence.

A case of adenosine triphosphate binding cassette transporter subfamily C member 8 was reported (ABCC8) Diagnosis and treatment of adult diabetes type 12 (MODY12) patients with adolescent onset caused by gene mutation. The patient is a 29-year-old female who visited the Department of Endocrinology, Affiliated Hospital of Inner Mongolia Medical University in June 2020 mainly because of "the physical examination found that blood sugar increased for 4 years". After admission, the relevant examinations were completed, and the laboratory results indicated that glycosylated hemoglobin (HbA_1c) 7.7%, fasting plasma glucose (FPG) 7.3 mmol/L, 2 h postprandial plasma glucose 14.4 mmol/L, Sanger sequencing results showed that patientsABCC8There was a heterozygous mutation of c.4369G>A (p.Ala1457Thr) in the gene. Combined with the patient's medical history data and gene sequencing results, it was clearly diagnosed as MODY12. Glimepiride (1 mg, once/d, orally before breakfast) and dapagliflozin (10 mg, once/d) were given. The follow-up patient had good blood glucose control and was pregnant on Nov. 6, 2022. 40⁺³The maximum dose of insulin was: 9 U of insulin detemir subcutaneously injected before bedtime, 6 U of insulin aspart subcutaneously injected immediately before meals in the morning, noon and evening, and the total dose of insulin was about 0.5 U · kg^-1• d^-1), the newborn was in good health, without hyperinsulinemia and hypoglycemia, and without related gene mutations.ABCC8MODY caused by gene mutation is a rare type of MODY and is easily misdiagnosed. This paper reported the diagnosis and treatment of a case of MODY12 caused by this gene locus mutation, hoping to be a reference for the diagnosis, differential diagnosis and treatment of diabetes mellitus.

This article reports the case of a 22-year-old female patient with abnormal blood glucose with young onset and no family history of diabetes as the main manifestation. Admission examination showed that glycosylated hemoglobin was 7.7%, islet autoantibody was negative, and certain endogenous insulin secretion function was retained. Whole exon sequencing revealed X-ray repair of cross-complementary protein 4 (XRCC4) gene heterozygous variation (c.695G>C). Focal nodular hyperplasia (FNH) of the liver was confirmed by pathology after previous liver occupation surgery, accompanied by subclinical hypothyroidism and decreased learning ability, but no typical cases such as microcephaly were foundXRCC4Characteristics of associated syndromes. In this case, metabolic abnormalities were the first manifestation, combined with mild involvement of multiple systems, suggesting thatXRCC4Related diseases may have atypical or mild phenotypic spectrum characterized by metabolic abnormalities, which has certain suggestive significance for unexplained young onset of blood glucose abnormalities without family history.

The epidemiology, classical mechanism and main types of biomechanical characteristics of diabetic foot deformity were systematically combed, and the research status of high arched foot was revealed by comparative analysis. The existing research on foot deformities in patients with type 2 diabetes mellitus (T2DM) is highly focused on Charcot foot, hammertoe and other deformities, but the epidemiology and risk factors of high arched foot in T2DM population have not been paid attention to. This review further proposes a core hypothesis of "biomechanical risk and acquired pathology interaction", that is, there is a bidirectional association between high arch foot and ulcer risk in diabetic foot, which is not only a precursor of synergistic amplification of ulcer risk, but also an acquired deformity formed after neuropathy triggers muscle imbalance. However, this hypothesis needs to be verified by empirical research. High arch foot is an important but long-neglected link in the prevention and control system of diabetic foot. Future research should follow the progressive route from epidemiological investigation to clinical intervention to fill this gap, which will provide theoretical basis for the identification and targeted intervention of this high-risk subgroup.

As one of the severe and complicated complications of diabetes, the effective management of diabetic foot is highly dependent on multidisciplinary collaboration. There are three main modes in the world: specialty-led type, hierarchical network type and whole-process management type. On this basis, China has built a multidisciplinary hierarchical whole-process management system in line with the characteristics of the medical system, covering the whole process from prevention, screening, diagnosis and treatment to rehabilitation. In this paper, the main international models and practices of multidisciplinary collaborative diagnosis and treatment of diabetic foot are systematically combed and analyzed, in order to provide reference for the optimization of comprehensive prevention and treatment system of diabetic foot in China.

Type 1 diabetes (T1D) is an autoimmune disease caused by the immune system attacking pancreatic islet β cells. Traditional insulin therapy can only control the symptoms of the disease, but cannot prevent the progression of the disease. In recent years, a variety of novel immunotherapy drugs targeting the immune destruction mechanism of T1D have been developed. This review systematically reviews a variety of T1D immunotherapy drugs such as T cell targeting, B cell targeting, and cytokine targeting, as well as the research progress of β cell replacement and regenerative therapies such as stem cell transplantation and islet cell transplantation in the field of T1D, focusing on summarizing the clinical research data of tilizumab, including its efficacy and safety in patients with stage 2 and 3 T1D, aiming to provide evidence-based support for immunotherapy of T1D.

In the article "Expert Consensus on Clinical Application of Non-invasive Blood Glucose Monitoring (2025 Edition)", Volume 17, Issue 12, 2025, Chinese Journal of Diabetes, the fund project deletes the National Science and Technology Major Project (2025ZD0550604) and retains only: National Key R&D Plan (2022YFB3203700), which is hereby corrected.