The purpose of this review is to synthesize literature investigating the relationship between type 2 diabetes (T2D) and obstructive airway diseases and to identify implications for clinical care. Type 2 diabetes is a common and challenging comorbidity in patients with asthma and chronic obstructive pulmonary disease (COPD). Basic, translational and clinical studies support a bidirectional association between T2D and the lung. In animal models and human studies, insulin resistance and hyperglycemia are associated with pulmonary inflammation, respiratory exacerbation risk and disease severity. Corticosteroids are a mainstay for respiratory disease control and exacerbation treatment but promote ongoing metabolic dysregulation. Randomized, placebo-controlled trials of glucose-lowering medications for asthma are actively ongoing. Additional studies addressing clinical pathways to co-manage respiratory and metabolic risk are needed. Patients with comorbid T2D and asthma or COPD are at risk for worse outcomes. There are opportunities to improve cross-disciplinary care, potentially reducing risk and multimorbidity associated with both conditions.

Most youth with type 1 diabetes (T1D) do not meet the guidelines for physical activity engagement, thereby diminishing potential benefits to physical and mental health. This review synthesizes the recent literature on physical activity among youth with T1D and offers recommendations for future research. Studies highlight challenges related to the use of inconsistent measurement tools, which prevent definitive conclusions about the mechanistic factors underlying low physical activity in youth. There has been limited research examining young children and youth newly diagnosed with T1D. Additionally, most interventions to promote physical activity in youth with T1D have involved structured and supervised exercise sessions, leaving a gap in knowledge regarding the potential impact of unstructured and unsupervised exercise interventions. To address these gaps, rigorous studies employing validated measures of physical activity in youth are needed. Interventions should incorporate developmentally appropriate behavioral science theories and emerging technologies in their design. Additional priorities include integrating diabetes technologies into clinical care, more real-world data to improve the accuracy of machine learning models for predicting dysglycemia, and advancing personalized mHealth interventions to promote physical activity in youth. While physical activity is an important area of pediatric diabetes research, gaps remain in our knowledge and intervention development. Physical activity consultations should be a part of routine diabetes care for youth. Research can inform these consultations by providing strategies to promote physical activity uptake and maintenance and by exploring ways to leverage new technologies to help youth with T1D exercise safely.

To synthesize the components of diabetes prevention programs (DPPs) after gestational diabetes mellitus (GDM) and how they relate to factors that influence implementation. We conducted a scoping review of the literature using MEDLINE, Embase, PsychINFO, and Emcare. We provided a narrative description of intervention components based on the Template for Intervention Description and Replication (TIDieR) and the study results based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Seventeen included studies described DPPs after GDM. Recruitment typically began during pregnancy, while interventions started postpartum, with higher reach and participation rates for studies that recruited during pregnancy. The included DPPs used face-to-face delivery, virtual delivery, or a combination. Many programs were individual, but a few had a group component. Program duration varied from one month to three years. The available data highlighted the need to increase engagement, particularly for minority groups, and utilize flexibility and tailoring of program components and delivery to optimize retention, impact and sustainability. Significant barriers to the successful implementation of DPPs after GDM exist; the reporting of intervention components and implementation outcomes in the existing studies is variable. Validated frameworks, including RE-AIM, should be integrated into intervention development, implementation and evaluation.

Early Gestational Diabetes Mellitus (eGDM) is an emerging public health issue in India, characterised by varying prevalence estimates, healthcare access disparities, and inconsistent screening practices. This scoping review aims to map the existing literature on eGDM screening in India, identify evidence gaps, and inform future research, policy formulation, and resource allocation. The review, guided by the Arksey and O'Malley framework, includes studies published between 2000 and 2024 that highlight significant eGDM screening and management disparities across public and private healthcare settings, rural-urban locations, and socioeconomic groups. Several screening initiatives have been introduced, but challenges persist, including a lack of standardised diagnostic criteria, low healthcare provider awareness, limited accessibility of screening, and sociocultural barriers. Economic evaluations suggest that eGDM screening can be cost-effective, yet India-specific assessments remain scarce. The integration of eGDM screening within India's national healthcare programs, including NPCDCS, remains minimal. There is a significant gap in knowledge translation, with limited efforts in adapting research findings into policy and practice. Addressing these challenges requires robust policy and programmatic responses, including standardised diagnostic guidelines, improved healthcare provider training, equitable service access, and culturally sensitive community engagement. Strengthening research-to-policy pathways is critical to improving eGDM screening and outcomes across India.

Care guidelines recommend screening and intervention for diabetes distress (DD) as part of standard type 1 diabetes (T1D) care. The variability in how individuals with diabetes experience distress, alongside the range of treatment options, underscores the value of tailoring approaches for addressing diabetes distress. Our objective was to summarize contemporary clinical trials addressing DD directly in adults with T1D, focusing on evidence of heterogenous treatment effects. We reviewed five studies testing diverse intervention strategies, including emotional support, telehealth, digital health platforms, and patient-centered communication. All studies were effective in reducing DD. Four studies examined the variation in treatment effects or outcomes in relation to observable participant characteristics and demonstrated heterogeneity both in the factors associated with changes in DD and factors associated with the differential impact of specific interventions. This review uncovered preliminary evidence of heterogeneous treatment effects across a range of DD-focused interventions. Gaining a deeper, more comprehensive understanding of the individuals or subgroups for whom evidence-based DD strategies are particularly effective versus less effective is needed to advance data-driven personalized treatment for DD. Future studies should prioritize diversity in enrolled individuals and advanced analytic approaches that can empirically match individuals with elevated DD to their optimal treatment approach.

This review highlights the impact of weight loss on metabolic dysfunction associated steatotic liver disease (MASLD), formally known as nonalcoholic fatty liver disease (NAFLD), and its progressive form of metabolic dysfunction associated steatohepatitis (MASH), formally known as nonalcoholic steatohepatitis (NASH). The effects of weight loss, as achieved through lifestyle modification, pharmacotherapy, bariatric surgery or endobariatric procedures on MASLD/MASH and hepatic fibrosis are discussed. Although foundational in the treatment of MASLD/MASH, weight loss through life-style modification is challenging for most patients to achieve and sustain long-term. In patients with MASLD/MASH, a multidisciplinary approach may facilitate success with lifestyle modification, individualized consideration of pharmacotherapies and/or surgical approaches that have potential to lend an improvement in MASLD/MASH. Effective and sustained weight loss improves hepatic steatosis, steatohepatitis and potentially hepatic fibrosis. Improvement in hepatic fibrosis can improve patient-related outcomes associated with complications of advanced hepatic fibrosis or cirrhosis in patients with MASLD/MASH. Identifying risk factors that influence MASLD/MASH and early implementation of therapeutic weight loss strategies may improve chronic liver injury and decrease risk for adverse clinical outcomes related to progressive hepatic fibrosis attributable to MASLD/MASH.

Purpose of ReviewThe prevalence of diabetes is rising around the world and represents an important public health concern. Unlike individual-level risk and protective factors related to the etiology of diabetes, contextual risk factors have been much less studied. Identification of contextual factors related to the risk of type 1 and type 2 diabetes in Organisation for Economic Co-operation and Development (OECD) countries may help health professionals, researchers, and policymakers to improve surveillance, develop policies and programs, and allocate funding.Recent FindingsAmong 4,470 potential articles, 48 were included in this review. All reviews were published in English between 2005 and 2023 and were conducted in over 20 different countries. This review identified ten upstream contextual risk factors related to type 1 and type 2 diabetes risk, including income, employment, education, immigration, race/ethnicity, geography, rural/urban status, built environment, environmental pollution, and food security/environment.SummaryThe ten upstream contextual risk factors identified this review may be integrated into diabetes research, surveillance and prevention activities to help promote better outcomes for people at risk or living with diabetes in OECD countries. Additional research is needed to better quantify the measures of associations between emerging key contextual factors and diabetes outcomes.

Hypoglycemia has been shown to increase mortality and length of hospital stay and is now reportable to the Centers for Medicare and Medicaid Services as a quality measure. The purpose of this article is to review clinical decision support (CDS) tools designed to reduce inpatient hypoglycemic events. CDS tools such as order set development, medication alerts, and data visibility have all been shown to be valuable tools in improving glycemic performance. This is especially true for hyperglycemic events with mixed results in hypoglycemia prevention. CDS solutions may be targeted directly to healthcare professionals or to specialty diabetes management teams to reduce hypoglycemia. Not all organizations have the financial resources to develop a diabetes management team so non-interruptive alerts may serve as an important tool to alert health care professionals of individuals with additional risk factors for the development of hypoglycemia. CDS can provide a mechanism to reduce the risk of hypoglycemia in hospitalized individuals. Although new research is promising, more studies are needed to determine future directions including the impact and feasibility of continuous glucose monitoring and predictive models to improve overall glycemic performance.

Purpose of ReviewDescribe the connection between Deaf/hard of hearing (DHH) and diabetes, explain the bidirectional relationship of blind/low vision (BLV) and diabetes, characterize challenges DHH and BLV populations face when seeking healthcare regarding their diabetes management. Highlight the inaccessibility of diabetes technology in these populations. Provide best practices when communicating with DHH and BLV people in the clinical setting. Recent FindingsDiabetes disparities exist in DHH and BLV populations due to systemic barriers to health equity related to access and communication. Structural barriers, risk factors, social determinants of health, and the U.S. healthcare system do not support the DHH and BLV communities. Importantly, healthcare professionals do not receive adequate training on communication and treatment of DHH and BLV populations. Together, social determinants of health, such as healthcare access and quality, education access and quality, and lack of adequate clinician training allow ableism to persist and drive health disparities in these communities.SummaryHealth disparities faced by DHH and BLV populations are driven by barriers to diabetes standards of care. These inequities must be rectified to improve and maintain high quality care.

The aim of this review is to provide an updated commentary on the current literature examining the impact of normal weight obesity (NWO) and normal weight central obesity (NWCO) on type 2 diabetes mellitus in adults. Total 14 studies were included, comprising 9 cross-sectional and 5 cohort studies with 334,438 subjects. The quality of evidence was mixed. The pooled prevalence of NWO was 16.1% (95% CI: 12.7-19.4) and NWCO was 21.1% (95% CI: 12.2-30.1). The prevalence of NWO and NWCO higher in females and non-Asians. This review also showed that type 2 diabetes was significantly associated with NWO and NWCO (pooled OR: 1.82 [1.62, 2.04], p < 0.01, I2 = 64%). Subgroup analyses revealed consistent relationships between type 2 diabetes and NWO/NWCO across sex, region and definition approach. There was a relative high prevalence of NWO and NWCO, particularly in females and non-Asian populations. There was a consistent association of NWO/NWCO with type 2 diabetes. Implications for future research to guide intervention optimization in clinical practice and public health promotion are provided.