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Scherrer JF, Salas J, Wang W, Freedland KE, Lustman PJ, Schnurr PP, Cohen BE, Jaffe AS, Friedman MJ. Posttraumatic Stress Disorder and Type 2 Diabetes Outcomes in Veterans. JAMA Netw Open 2024; 7:e2427569. [PMID: 39136942 PMCID: PMC11322846 DOI: 10.1001/jamanetworkopen.2024.27569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/17/2024] [Indexed: 08/15/2024] Open
Abstract
Importance Posttraumatic stress disorder (PTSD) symptom reduction is linked with lower risk of incident type 2 diabetes (T2D), but little is known about the association between PTSD and comorbid T2D outcomes. Whether PTSD is a modifiable risk factor for adverse T2D outcomes is unknown. Objective To determine whether patients with PTSD who improved and no longer met diagnostic criteria for PTSD had a lower risk of adverse T2D outcomes compared with patients with persistent PTSD. Design, Setting, and Participants This retrospective cohort study used deidentified data from US Veterans Health Administration (VHA) historical medical records (from October 1, 2011, to September 30, 2022) to create a cohort of patients aged 18 to 80 years with comorbid PTSD and T2D. Data analysis was performed from March 1 to June 1, 2024. Exposures Diagnoses of PTSD and T2D. Main Outcomes and Measures The main outcomes were insulin initiation, poor glycemic control, any microvascular complication, and all-cause mortality. Improvement of PTSD was defined as no longer meeting PTSD diagnostic criteria, per a PTSD Checklist score of less than 33. Entropy balancing controlled for confounding. Survival and competing risk models estimated the association between meeting PTSD criteria and T2D outcomes. Subgroup analyses examined variation by age, sex, race, PTSD severity, and comorbid depression status. Results The study cohort included 10 002 veterans. More than half of patients (65.3%) were aged older than 50 years and most (87.2%) were men. Patients identified as Black (31.6%), White (62.7%), or other race (5.7%). Before controlling for confounding with entropy balancing, patients who no longer met PTSD diagnostic criteria had similar incidence rates for starting insulin (22.4 vs 24.4 per 1000 person-years), poor glycemic control (137.1 vs 133.7 per 1000 person-years), any microvascular complication (108.4 vs 104.8 per 1000 person-years), and all-cause mortality (11.2 vs 11.0 per 1000 person-years) compared with patients with persistent PTSD. After controlling for confounding, no longer meeting PTSD criteria was associated with a lower risk of microvascular complications (hazard ratio [HR], 0.92 [95% CI, 0.85-0.99]). Among veterans aged 18 to 49 years, no longer meeting PTSD criteria was associated with a lower risk of insulin initiation (HR, 0.69 [95% CI, 0.53-0.88]) and all-cause mortality (HR, 0.39 [95% CI, 0.19-0.83]). Among patients without depression, no longer meeting PTSD criteria was associated with a lower risk of insulin initiation (HR, 0.73 [95% CI, 0.55-0.97]). Conclusions and Relevance The findings of this cohort study of patients with comorbid PTSD and T2D suggest that PTSD is a modifiable risk factor associated with a modest reduction in microvascular complications. Further research is needed to determine whether findings are similar in non-VHA health care settings.
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Affiliation(s)
- Jeffrey F. Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St Louis, Missouri
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St Louis, Missouri
- Advanced Health Data Research Institute, Saint Louis University School of Medicine, St Louis, Missouri
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, Missouri
| | - Joanne Salas
- Advanced Health Data Research Institute, Saint Louis University School of Medicine, St Louis, Missouri
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, Missouri
| | - Wenjin Wang
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St Louis, Missouri
| | - Kenneth E. Freedland
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Patrick J. Lustman
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Paula P. Schnurr
- National Center for PTSD, White River Junction, Vermont
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Beth E. Cohen
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco
- San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Allan S. Jaffe
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Matthew J. Friedman
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
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Bae JH, Park EH, Lee HK, Yoon KH, Won KC, Kim HM, Kim SG. Enhancing Diabetes Care through a Mobile Application: A Randomized Clinical Trial on Integrating Physical and Mental Health among Disadvantaged Individuals. Diabetes Metab J 2024; 48:790-801. [PMID: 38310877 PMCID: PMC11307109 DOI: 10.4093/dmj.2023.0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/16/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGRUOUND This study examines integrating physical and mental healthcare for disadvantaged persons with type 2 diabetes mellitus and mild-to-moderate depression in the community, using a mobile application within a public-private-academic partnership. METHODS The Korean Diabetes Association has developed a mobile application combining behavioral activation for psychological well-being and diabetes self-management, with conventional medical therapy. Participants were randomly assigned to receive the application with usual care or only usual care. Primary outcomes measured changes in psychological status and diabetes selfmanagement through questionnaires at week 12 from the baseline. Secondary outcomes assessed glycemic and lipid control, with psychological assessments at week 16. RESULTS Thirty-nine of 73 participants completed the study (20 and 19 in the intervention and control groups, respectively) and were included in the analysis. At week 12, the intervention group showed significant reductions in depression severity and perceived stress compared to the control group. Additionally, they reported increased perceived social support and demonstrated improved diabetes self-care behavior. These positive effects persisted through week 16, with the added benefit of reduced anxiety. While fasting glucose levels in the intervention group tended to improve, no other significant differences were observed in laboratory assessments between the groups. CONCLUSION This study provides compelling evidence for the potential efficacy of a mobile application that integrates physical and mental health components to address depressive symptoms and enhance diabetes self-management in disadvantaged individuals with type 2 diabetes mellitus and depression. Further research involving larger and more diverse populations is warranted to validate these findings and solidify their implications.
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Affiliation(s)
- Jae Hyun Bae
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Eun Hee Park
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea
| | | | - Kun Ho Yoon
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyu Chang Won
- Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | | | - Sin Gon Kim
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Duquenne P, Samieri C, Chambaron S, Brindisi MC, Kesse-Guyot E, Galan P, Hercberg S, Touvier M, Léger D, Fezeu LK, Andreeva VA. Chronic insomnia, high trait anxiety and their comorbidity as risk factors for incident type 2 diabetes mellitus. Sci Rep 2024; 14:11927. [PMID: 38789594 PMCID: PMC11126668 DOI: 10.1038/s41598-024-62675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/20/2024] [Indexed: 05/26/2024] Open
Abstract
The main objective of this study was to evaluate the association of the insomnia-anxiety comorbidity with incident type 2 diabetes (T2D) in a large prospective cohort. We selected adults without diabetes at baseline from the French NutriNet-Santé cohort who had completed the trait anxiety subscale of the Spielberger State-Trait Anxiety Inventory (STAI-T, 2013-2016) and a sleep questionnaire (2014); insomnia was defined according to established criteria. Using multivariable Cox models, we compared T2D risk across 4 groups: no insomnia or anxiety (reference), insomnia alone, anxiety alone (STAI-T ≥ 40), and comorbid anxiety and insomnia. Among 35,014 participants (mean baseline age: 52.4 ± 14.0 years; 76% women), 378 (1.1%) developed T2D over a mean follow-up of 5.9 ± 2.1 years. Overall, 28.5% of the sample had anxiety alone, 7.5%-insomnia alone, and 12.5%-both disorders. In the fully-adjusted model, a higher T2D risk was associated with anxiety-insomnia comorbidity (HR = 1.40; 95% CI 1.01, 1.94), but not with each disorder separately, compared to the group without insomnia or anxiety. The findings supported a positive association between anxiety-insomnia comorbidity and incident T2D among general-population adults. Future research using clinical diagnoses of mental disorders could confirm the findings and guide diabetes prevention programs.
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Affiliation(s)
- Pauline Duquenne
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France.
| | - Cécilia Samieri
- Bordeaux Population Health, INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Stéphanie Chambaron
- Center for Taste and Feeding Behavior, CNRS, INRAE, Agro Dijon Institute, University of Burgundy, Dijon, France
| | - Marie-Claude Brindisi
- Center for Taste and Feeding Behavior, CNRS, INRAE, Agro Dijon Institute, University of Burgundy, Dijon, France
- University Hospital Center, Dijon, France
| | - Emmanuelle Kesse-Guyot
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France
| | - Pilar Galan
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France
| | - Serge Hercberg
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France
- Department of Public Health, AP-HP Paris Seine-Saint-Denis Hospital System, Bobigny, France
| | - Mathilde Touvier
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France
| | - Damien Léger
- Université Paris Cité, VIFASOM, APHP Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Léopold K Fezeu
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France
| | - Valentina A Andreeva
- INSERM, INRAE, CNAM, Center for Research in Epidemiology and Statistics (CRESS), Nutritional Epidemiology Research Team (EREN), SMBH, Sorbonne Paris Nord University and Paris Cité University, 74 Rue Marcel Cachin, 93017, Bobigny, France.
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
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Galiero R, Caturano A, Vetrano E, Monda M, Marfella R, Sardu C, Salvatore T, Rinaldi L, Sasso FC. Precision Medicine in Type 2 Diabetes Mellitus: Utility and Limitations. Diabetes Metab Syndr Obes 2023; 16:3669-3689. [PMID: 38028995 PMCID: PMC10658811 DOI: 10.2147/dmso.s390752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the most widespread diseases in Western countries, and its incidence is constantly increasing. Epidemiological studies have shown that in the next 20 years. The number of subjects affected by T2DM will double. In recent years, owing to the development and improvement in methods for studying the genome, several authors have evaluated the association between monogenic or polygenic genetic alterations and the development of metabolic diseases and complications. In addition, sedentary lifestyle and socio-economic and pandemic factors have a great impact on the habits of the population and have significantly contributed to the increase in the incidence of metabolic disorders, obesity, T2DM, metabolic syndrome, and liver steatosis. Moreover, patients with type 2 diabetes appear to respond to antihyperglycemic drugs. Only a minority of patients could be considered true non-responders. Thus, it appears clear that the main aim of precision medicine in T2DM is to identify patients who can benefit most from a specific drug class more than from the others. Precision medicine is a discipline that evaluates the applicability of genetic, lifestyle, and environmental factors to disease development. In particular, it evaluated whether these factors could affect the development of diseases and their complications, response to diet, lifestyle, and use of drugs. Thus, the objective is to find prevention models aimed at reducing the incidence of pathology and mortality and therapeutic personalized approaches, to obtain a greater probability of response and efficacy. This review aims to evaluate the applicability of precision medicine for T2DM, a healthcare burden in many countries.
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Affiliation(s)
- Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Teresa Salvatore
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Lindekilde N, Diaz LJ, Lasgaard M, Henriksen JE, Scheuer SH, Andersen GS, Rubin KH, Pouwer F. Elevated risk of developing type 2 diabetes in people with a psychiatric disorder: What is the role of health behaviors and psychotropic medication? J Diabetes Complications 2023; 37:108591. [PMID: 37820469 DOI: 10.1016/j.jdiacomp.2023.108591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/31/2023] [Accepted: 08/19/2023] [Indexed: 10/13/2023]
Abstract
AIMS Several psychiatric disorders are linked with an increased risk of developing type 2 diabetes (T2D), but the mediating mechanisms are unclear. We aimed to investigate health behaviors, obesity, psychotropic medication use, and comorbidity as potential mediating mechanisms explaining these associations. METHODS We combined data from a large population-based survey with register-based data and followed a sample of 250,013 Danes (≥16 years) for up to 8.9 years. We conducted mediation analyses investigating 10 potential mediators of the associations between psychiatric disorders and incident T2D. RESULTS Individuals with a substance use disorder, schizophrenia, mood disorder, neurotic disorder, eating disorder, or a personality disorder had a significantly higher risk of developing T2D. Organic disorders, intellectual disabilities, developmental and behavioral disorders were not associated with T2D-risk. For all psychiatric disorders significantly associated with T2D, the use of antidepressant medication had the largest proportional mediating effect on the association (13-32 %). CONCLUSIONS Use of antidepressant medication had the largest contribution to the associations between psychiatric disorders and incident T2D. Future epidemiological studies and prevention studies should focus on optimizing the use of antidepressant medication with minimal side effects, and the promotion of health behaviors in individuals with a psychiatric disorder to prevent T2D.
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Affiliation(s)
- Nanna Lindekilde
- Department of Psychology, University of Southern Denmark, Odense, Denmark; Department of Occupational and Environmental Medicine, Odense University Hospital, Denmark.
| | - Lars J Diaz
- Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Mathias Lasgaard
- DEFACTUM - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
| | - Jan Erik Henriksen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | | | | | - Katrine H Rubin
- OPEN - Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, Department of Clinical Research, University of Southern Denmark, Denmark
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Medical Psychology, Amsterdam UMC, the Netherlands
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de Wit M, van Raalte DH, van den Berg K, Racca C, Muijs LT, Lutgers HL, Siegelaar SE, Serné E, Snoek FJ. Glucose variability and mood in people with type 1 diabetes using ecological momentary assessment. J Psychosom Res 2023; 173:111477. [PMID: 37643560 DOI: 10.1016/j.jpsychores.2023.111477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Mood fluctuations related to blood glucose excursions are a commonly reported source of diabetes-distress, but research is scarce. We aimed to assess the relationship between real-time glucose variability and mood in adults with type 1 diabetes (T1D) using ecological momentary assessments. METHODS In this prospective observational study, participants wore a masked continuous glucose monitor and received prompts on their smartphone 6 times a day to answer questions about their current mood (Profile Of Mood States (POMS)-SF (dimensions: Anxiety, Depressive symptoms, Anger, Fatigue, Vigor)) for 14 days. Mixed model analyses examined associations over time between daily Coefficient of Variation (CV) of blood glucose and mean and variability (CV) of POMS scores. Further, within-person differences in sleep and nocturnal hypoglycemia were explored. RESULTS 18 people with T1D (10 female, mean age 44.3 years) participated. A total of 264 out of 367 days (70.2%) could be included in the analyses. No overall significant associations were found between CV of blood glucose and mean and CV of POMS scores, however, nocturnal hypoglycemia moderated the associations between CV of blood glucose and POMS scales (mean Fatigue Estimate 1.998, p < .006, mean Vigor Estimate -3.308, p < .001; CV Anger Estimate 0.731p = 0.02, CV Vigor Estimate -0.525, p = .006). CONCLUSION We found no overall relationship between real-time glycemic variability and mood per day. Further research into within-person differences such as sleep and nocturnal hypoglycemia is warranted.
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Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands.
| | - Daniël H van Raalte
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Endocrinology and Metabolism, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Diabetes Center Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovasculair Science, Amsterdam, the Netherlands
| | - Kirsten van den Berg
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
| | - Catherina Racca
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Endocrinology and Metabolism, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Linda T Muijs
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
| | - Helen L Lutgers
- Medical Center Leeuwarden, Department of Internal Medicine, Leeuwarden, the Netherlands
| | - Sarah E Siegelaar
- Amsterdam UMC, location University of Amsterdam, Department of Endocrinology and Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands
| | - Erik Serné
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Endocrinology and Metabolism, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Diabetes Center Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovasculair Science, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
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Califf RM. Our National Approach to Diabetes. Diabetes Care 2023; 46:252-254. [PMID: 36701600 DOI: 10.2337/dci22-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 01/27/2023]
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Krook A, Mulder H. Pinpointing precision medicine for diabetes mellitus. Diabetologia 2022; 65:1755-1757. [PMID: 35997779 DOI: 10.1007/s00125-022-05777-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Anna Krook
- Department of Physiology and Pharmacology, Section of Integrative Physiology, Karolinska Institutet, Stockholm, Sweden.
| | - Hindrik Mulder
- Unit of Molecular Metabolism, Lund University Diabetes Centre, Malmö, Sweden
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