No direct effect of SGLT2 activity on glucagon secretion
AbstractAims/hypothesisSodium –glucose cotransporter (SGLT) 2 inhibitors constitute a new class of glucose-lowering drugs, but they increase glucagon secretion, which may counteract their glucose-lowering effect. Previous studies using static incubation of isolated human islets or the glucagon-secreting cell line α-TC1 sugges ted that this results from direct inhibition of alpha cell SGLT1/2-activity. The aim of this study was to test whether the effects of SGLT2 on glucagon secretion demonstrated in vitro could be reproduced in a more physiological setting.MethodsWe explored the effect of SGLT2 activity on glu...
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Gestational diabetes and the risk of cardiovascular disease in women: a systematic review and meta-analysis
Conclusions/interpretationThe diagnosis of GDM identifies young women who have a twofold higher risk of cardiovascular events postpartum compared with their peers. This risk is not dependent upon intercurrent type 2 diabetes and is apparent within the first decade after pregnancy. Thus, even without progressing to type 2 diabetes, women with GDM comprise an at-risk population for CVD and hence a potential opportunity for early risk factor surveillance and risk modification. (Source: Diabetologia)
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Effects of canagliflozin on amputation risk in type 2 diabetes: the CANVAS Program
Conclusions/interpretationThe CANVAS Program demonstrated that canagliflozin increased the risk of amputation (mainly minor) in this study population. Anticipated risk factors for amputation were identified, such as prior history of amputation, peripheral vascular disease and neuropathy, but no specific aetiological mechanism or at-risk subgroup for canagliflozin was identified. (Source: Diabetologia)
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Lower limb events in individuals with type 2 diabetes: evidence for an increased risk associated with diuretic use
AbstractAims/hypothesisRecently, safety data signalled an increased risk of amputations in people taking canagliflozin, a sodium −glucose cotransporter 2 (SGLT2) inhibitor. If this side effect is due to drug-induced hypovolaemia, diuretics should also increase that risk. The aim of this study was to analyse the association between diuretic use and the risk of lower limb events (LLEs) in people with type 2 diabetes.MethodsSURDIAGENE (SUivi R énal, DIAbète de type 2 et GENEtique) is a prospective observational cohort that includes people with type 2 diabetes enrolled from 2002 to 2012 and followed-up unti...
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Metformin-induced changes of the gut microbiota in healthy young men: results of a non-blinded, one-armed intervention study
AbstractAims/hypothesisIndividuals with type 2 diabetes have an altered bacterial composition of their gut microbiota compared with non-diabetic individuals. However, these alterations may be confounded by medication, notably the blood-glucose-lowering biguanide, metformin. We undertook a clinical trial in healthy and previously drug-free men with the primary aim of investigating metformin-induced compositional changes in the non-diabetic state. A secondary aim was to examine whether the pre-treatment gut microbiota was related to gastrointestinal adverse effects during metformin treatment.MethodsTwenty-seven healthy young...
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Eighteen-year alcohol consumption trajectories and their association with risk of type 2 diabetes and its related factors: the China Health and Nutrition Survey
This study aims to investigate the association of alcohol consumption trajectories with the risk of type 2 diabetes and its related factors.MethodsWeighted longitudinal data were obtained for 12,186 adults who completed a questionnaire about alcohol consumption and diabetes status as part of the China Health and Nutrition Survey (1993 –2011). Participants were designated into subgroups based on alcohol consumption trajectory, and subgroup analyses included 5436 individuals who were tested for specified diabetes-related factors. Light alcohol consumption was defined as fewer than seven standard drinks per week; modera...
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Underpowered or negative? A crucial distinction
(Source: Diabetologia)
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Large enteroviral vaccination studies to prevent type 1 diabetes should be well founded and rely on scientific evidence
(Source: Diabetologia)
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

Modulation of the p75 neurotrophin receptor using LM11A-31 prevents diabetes-induced retinal vascular permeability in mice via inhibition of inflammation and the RhoA kinase pathway
Conclusions/interpretationTargeting p75NTR signalling using LM11A-31, an orally bioavailable receptor modulator, may offer an effective, safe and non-invasive therapeutic strategy for treating macular oedema, a major cause of blindness in diabetes. (Source: Diabetologia)
Source: Diabetologia - May 9, 2019 Category: Endocrinology Source Type: research

ApoAI-derived peptide increases glucose tolerance and prevents formation of atherosclerosis in mice
Conclusions/interpretationThe RG54 peptide exhibits good prospects for providing glucose control and reducing the risk of cardiovascular disease in individuals with severe insulin resistance. (Source: Diabetologia)
Source: Diabetologia - May 8, 2019 Category: Endocrinology Source Type: research

Moderate weight change following diabetes diagnosis and 10  year incidence of cardiovascular disease and mortality
Conclusions/interpretationAmong adults with screen-detected diabetes, loss of ≥5% body weight during the year after diagnosis was associated with a lower hazard of CVD events compared with maintaining weight. These results support the hypothesis that moderate weight loss may yield substantial long-term CVD reduction, and may be an achievable target outside of specialist-led behavioural treatment programmes. (Source: Diabetologia)
Source: Diabetologia - May 7, 2019 Category: Endocrinology Source Type: research

Vascular endothelial PDPK1 plays a pivotal role in the maintenance of pancreatic beta cell mass and function in adult male mice
Conclusions/interpretationVascular endothelial PDPK1 plays an important role in the maintenance of pancreatic beta cell mass and function by maintaining vascularity of pancreas and islets and protecting them from hypoxia, hypoxia-related endoplasmic reticulum stress, inflammation and distortion of capillary structure. (Source: Diabetologia)
Source: Diabetologia - May 4, 2019 Category: Endocrinology Source Type: research

Novel therapeutic potential of angiotensin receptor 1 blockade in a rat model of diabetes-associated depression parallels altered BDNF signalling
Conclusions/interpretationWe identified a novel effect of losartan in the nervous system that may be implemented to alleviate symptoms of diabetes-associated depression. These findings explore a new therapeutic horizon for ARBs as possible antidepressants and suggest that BDNF could be a target of future drug development in diabetes-induced complications. (Source: Diabetologia)
Source: Diabetologia - May 3, 2019 Category: Endocrinology Source Type: research

Genome-wide association study of type 2 diabetes in Africa
Conclusions/interpretationThese results demonstrate the value of performing GWAS in Africans, provide a resource to larger consortia for further discovery and fine-mapping and indicate that additional large-scale efforts in Africa are warranted to gain further insight in to the genetic architecture of type 2 diabetes. (Source: Diabetologia)
Source: Diabetologia - May 2, 2019 Category: Endocrinology Source Type: research

Perinatal risk factors for type 1 diabetes revisited: a population-based register study
Conclusions/interpretationPerinatal factors make small but statistically significant contributions to the overall risk of childhood-onset type 1 diabetes. Some of these risk factors, such as maternal obesity, may be amendable with improved antenatal care. Better perinatal practices may have affected some previously noted risk factors over time. (Source: Diabetologia)
Source: Diabetologia - April 30, 2019 Category: Endocrinology Source Type: research

Up front
(Source: Diabetologia)
Source: Diabetologia - April 30, 2019 Category: Endocrinology Source Type: research

The impact of diabetes on productivity in China
Conclusions/interpretationOur study demonstrates the significant cumulative impact of diabetes on productivity across the working lifetime in the Chinese population, highlighting the potential economic benefits of diabetes prevention in the longer term. (Source: Diabetologia)
Source: Diabetologia - April 27, 2019 Category: Endocrinology Source Type: research

Human gut microbiota transferred to germ-free NOD mice modulate the progression towards type 1 diabetes regardless of the pace of beta cell function loss in the donor
This study aimed to assess the ability of human gut microbiota to delay the onset of type 1 diabetes when transferred into germ-free NOD mice.MethodsTwo children with rapid and three children with slow beta cell function loss (as assessed by C-peptide AUC change in the mixed-meal tolerance tests performed 1 and 12  months after type 1 diabetes onset), participating in an ongoing trial with gluten-free diet, donated faeces, which were transferred into germ-free NOD mice. The mice were subsequently followed for diabetes incidence.ResultsThe bacterial profiles of bacteriome-humanised mice had significantly (p 
Source: Diabetologia - April 25, 2019 Category: Endocrinology Source Type: research

Nerve growth factor gene therapy improves bone marrow sensory innervation and nociceptor-mediated stem cell release in a mouse model of type 1 diabetes with limb ischaemia
AbstractAims/hypothesisSensory neuropathy is common in people with diabetes; neuropathy can also affect the bone marrow of individuals with type 2 diabetes. However, no information exists on the state of bone marrow sensory innervation in type 1 diabetes. Sensory neurons are trophically dependent on nerve growth factor (NGF) for their survival. The aim of this investigation was twofold: (1) to determine if sensory neuropathy affects the bone marrow in a mouse model of type 1 diabetes, with consequences for stem cell liberation after tissue injury; and (2) to verify if a single systemic injection of theNGF gene exerts long-...
Source: Diabetologia - April 24, 2019 Category: Endocrinology Source Type: research

Cardiorespiratory fitness, muscular strength and risk of type 2 diabetes: a systematic review and meta-analysis
Conclusions/interpretationRelatively small increments in cardiorespiratory fitness and muscle strength were associated with clinically meaningful reductions in type 2 diabetes risk with indication of a linear dose –response relationship for cardiorespiratory fitness.Registration: PROSPERO (CRD42017064526). (Source: Diabetologia)
Source: Diabetologia - April 23, 2019 Category: Endocrinology Source Type: research

Large enteroviral vaccination studies to prevent type 1 diabetes should be well founded and rely on scientific evidence. Reply to Skog O, Klingel K, Roivainen M et al [letter]
(Source: Diabetologia)
Source: Diabetologia - April 23, 2019 Category: Endocrinology Source Type: research

Effects of long-term exercise on plasma adipokine levels and inflammation-related gene expression in subcutaneous adipose tissue in sedentary dysglycaemic, overweight men and sedentary normoglycaemic men of healthy weight
Conclusions/interpretationThis study indicates that scWAT may be an important mediator of exercise-induced improvements in insulin sensitivity, especially in overweight dysglycaemic individuals at increased risk of developing type 2 diabetes. (Source: Diabetologia)
Source: Diabetologia - April 22, 2019 Category: Endocrinology Source Type: research

Trends in overall, cardiovascular and cancer-related mortality among individuals with diabetes reported on death certificates in the United States between 2007 and 2017
Conclusions/interpretationCurrent national estimates capture about 30% of all-cause mortality among individuals with diabetes listed as underlying or contributing cause of death on death certificates. The age-standardised mortality due to diabetes as underlying or contributing cause of death and cause-specific mortality from CVD in individuals with diabetes listed as underlying or contributing cause of death plateaued from 2014 onwards except for hypertensive heart disease and heart failure. (Source: Diabetologia)
Source: Diabetologia - April 22, 2019 Category: Endocrinology Source Type: research

Elevated brain glutamate levels in type 1 diabetes: correlations with glycaemic control and age of disease onset but not with hypoglycaemia awareness status
Conclusions/interpretationIn conclusion, brain glutamate levels are elevated in people with type 1 diabetes and correlate with glycaemic control and age of disease diagnosis, but not with burden of hypoglycaemia as reflected by IAH. This suggests a potential role for glutamate as an early marker of hyperglycaemia-induced cerebral complications of type 1 diabetes.ClinicalTrials.gov NCT03286816; NCT02146404; NCT02308293 (Source: Diabetologia)
Source: Diabetologia - April 19, 2019 Category: Endocrinology Source Type: research

Canagliflozin reduces inflammation and fibrosis biomarkers: a potential mechanism of action for beneficial effects of SGLT2 inhibitors in diabetic kidney disease
AbstractAims/hypothesisThe sodium –glucose cotransporter 2 (SGLT2) inhibitor canagliflozin slows progression of kidney function decline in type 2 diabetes. The aim of this study was to assess the effect of the SGLT2 inhibitor canagliflozin on biomarkers for progression of diabetic kidney disease (DKD).MethodsA canagliflozin mechanism of action (MoA) network model was constructed based on an in vitro transcriptomics experiment in human proximal tubular cells and molecular features linked to SGLT2 inhibitors from scientific literature. This model was mapped onto an established DKD network model that describes molecular...
Source: Diabetologia - April 17, 2019 Category: Endocrinology Source Type: research

Bone marrow pericyte dysfunction in individuals with type 2 diabetes
Conclusions/interpretationThis is the first demonstration of pericyte dysfunction in bone marrow of people with type 2 diabetes. An altered angiocrine signalling from pericytes may participate in bone marrow microvascular remodelling in individuals with diabetes. (Source: Diabetologia)
Source: Diabetologia - April 17, 2019 Category: Endocrinology Source Type: research

Underpowered or negative? A crucial distinction. Reply to Dollerup OL, Treebak JT, Jessen N [letter]
(Source: Diabetologia)
Source: Diabetologia - April 13, 2019 Category: Endocrinology Source Type: research

Molecular regulation of the renin –angiotensin system by sodium–glucose cotransporter 2 inhibition in type 1 diabetes mellitus
(Source: Diabetologia)
Source: Diabetologia - April 11, 2019 Category: Endocrinology Source Type: research

Metformin increases endogenous glucose production in non-diabetic individuals and individuals with recent-onset type 2 diabetes
In this study, we investigated the glucose-lowering effects of metformin in individuals with type 2 diabetes and non-diabetic individuals.MethodsWe performed a randomised, placebo-controlled trial in 24 individuals with recent-onset type 2 diabetes (diabetes duration 50 [48] months) who had good glycaemic control (HbA1c 48  mmol/mmol [6.5%]). The studies were conducted at Aarhus University Hospital between 2013 and 2016. Participants were randomised to receive either metformin (2000 mg/day,n = 12, MET group) or placebo (n = 12, PLA group) for 90 days, using block randomisation set...
Source: Diabetologia - April 11, 2019 Category: Endocrinology Source Type: research

Type 1 diabetes defined by severe insulin deficiency occurs after 30  years of age and is commonly treated as type 2 diabetes
AbstractAims/hypothesisLate-onset type 1 diabetes can be difficult to identify. Measurement of endogenous insulin secretion using C-peptide provides a gold standard classification of diabetes type in longstanding diabetes that closely relates to treatment requirements. We aimed to determine the prevalence and characteristics of type 1 diabetes defined by severe endogenous insulin deficiency after age 30 and assess whether these individuals are identified and managed as having type 1 diabetes in clinical practice.MethodsWe assessed the characteristics of type 1 diabetes defined by rapid insulin requirement (within 3  y...
Source: Diabetologia - April 10, 2019 Category: Endocrinology Source Type: research

Digital health technology and mobile devices for the management of diabetes mellitus: state of the art
AbstractDiabetes mellitus is a disease that can be difficult to manage and requires high levels of health literacy and numeracy, self-monitoring and frequent contact with clinicians. If not optimally controlled, diabetes can lead to kidney failure, blindness and cardiovascular complications, which, in turn, contribute to increasing healthcare costs. Although not yet widely used, mobile health (mHealth) tools have enhanced diabetes management and prevention and are likely to play an increasing role with the growth of smartphone ownership and medical device innovations. Recent mHealth interventions targeting type 1 and type ...
Source: Diabetologia - April 8, 2019 Category: Endocrinology Source Type: research

Pre-diagnostic plasma enterolactone concentrations are associated with lower mortality among individuals with type 2 diabetes: a case-cohort study in the Danish Diet, Cancer and Health cohort
Conclusions/interpretationBased on this large cohort of people with diabetes with detailed and complete baseline and follow-up information, pre-diagnostic enterolactone concentrations were inversely associated with mortality. To our knowledge, this is the first study on enterolactone and type 2 diabetes mortality. Our findings call for further exploration of enterolactone in type 2 diabetes management. (Source: Diabetologia)
Source: Diabetologia - April 8, 2019 Category: Endocrinology Source Type: research

Spontaneous ketonuria and risk of incident diabetes: a 12  year prospective study
Conclusions/interpretationThe presence of spontaneous fasting ketonuria was significantly associated with a reduced risk of diabetes, independently of metabolic variables. Our findings suggest that spontaneous fasting ketonuria may have a potential preventive role in the development of diabetes. (Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Lean mass, grip strength and risk of type 2 diabetes: a bi-directional Mendelian randomisation study
Conclusions/interpretationIncreased muscle mass and strength may be related to lower diabetes risk. Diabetes may also be associated with grip strength and lean mass. Muscle strength could warrant further investigation as a possible target of intervention for diabetes prevention. (Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Selective deletion of endothelial cell calpain in mice reduces diabetic cardiomyopathy by improving angiogenesis
Conclusions/interpretationThese results delineate a primary role of calpain in inducing cardiac endothelial cell injury and impairing neovascularisation via suppression of β-catenin, thereby promoting diabetic cardiomyopathy, and indicate that calpain is a promising therapeutic target to prevent diabetic cardiac complications. (Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Cytoplasmic ends of tetraspanin 7 harbour epitopes recognised by autoantibodies in type 1 diabetes
Conclusions/interpretationWe hypothesise that conformation and, potentially, modification of protein terminal ends of tetraspanin 7 may be important for autoantibody binding in type 1 diabetes. (Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

No evidence of a causal association of type 2 diabetes and glucose metabolism with atrial fibrillation
Conclusions/interpretationThis Mendelian randomisation analysis does not support a causal role of clinical significance between genetically programmed type 2 diabetes, FBG or HbA1c and development of atrial fibrillation. These data suggest that drug treatment to reduce dysglycaemia is unlikely to be an effective strategy for atrial fibrillation prevention.Data availabilityThe datasets analysed during the current study are available from the following repository: Nielsen JB, Thorolfsdottir RB, Fritsche LG, et al (2018) GWAS summary statistics for AF (N=60,620 AF cases and 970,216 controls). Center for Statistical Genetics:h...
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Up front
(Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Alcohol consumption and incident diabetes: The Atherosclerosis Risk in Communities (ARIC) study
AbstractAims/hypothesisThe aim of this study was to evaluate the prospective association between baseline and 9  year change in alcohol consumption and long-term risk of diabetes and whether these associations might be modified by sex and/or BMI.MethodsWe conducted a prospective analysis of 12,042 Atherosclerosis Risk in Communities (ARIC) study participants without prevalent diabetes (55% women, 78% white, mean age 54  years). Alcohol consumption was assessed at visit 1 (1987–1989) and visit 4 (1996–1998). We used Cox models to estimate hazard ratios for diabetes risk by baseline drinking categories ...
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Exploring the association between BMI and mortality in Australian women and men with and without diabetes: the AusDiab study
AbstractAims/hypothesisThere is conflicting evidence about the obesity paradox —the counterintuitive survival advantage of obesity among certain subpopulations of individuals with chronic conditions. It is believed that results supporting the obesity paradox are due to methodological flaws, such as collider bias. The aim of this study was to examine the association between o besity and mortality in Australian men and women. In addition, we explored whether obesity would appear to be protective if the analysis was restricted to a subpopulation with disease, and to discuss the potential role of collider bias in produci...
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Correction to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
The affiliation details for Geltrude Mingrone are corrected below. (Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Correction to: One hour post-load plasma glucose and 3 year risk of worsening fasting and 2 hour glucose tolerance in the RISC cohort
The affiliation details for Geltrude Mingrone are corrected below. (Source: Diabetologia)
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Imaging mass spectrometry enables molecular profiling of mouse and human pancreatic tissue
Conclusions/interpretationThe development of more complete molecular profiles of pancreatic tissue will provide important insight into the molecular state of the pancreas during islet development, normal function, and diseased states. For example, this study demonstrates that these results can provide novel insight into the potential signalling mechanisms involving phospholipids and glycolipids that would be difficult to detect by targeted methods, and can help raise new hypotheses about the types of physiological control exerted on endocrine hormone-producing cells in islets. Importantly, the in situ measurements afforded...
Source: Diabetologia - April 6, 2019 Category: Endocrinology Source Type: research

Efficacy and safety of evolocumab in individuals with type 2 diabetes mellitus: primary results of the randomised controlled BANTING study
AbstractAims/hypothesisThe study aimed to examine the efficacy of 12  weeks of monthly evolocumab or placebo in lowering LDL-cholesterol (LDL-C) in individuals with type 2 diabetes and hypercholesterolaemia or mixed dyslipidaemia and on a maximum-tolerated statin of at least moderate intensity.MethodsFor this randomised, placebo-controlled outpatient study, eligible individuals were ≥18 years old with type 2 diabetes, HbA1c
Source: Diabetologia - April 5, 2019 Category: Endocrinology Source Type: research

Glucose controls glucagon secretion by directly modulating cAMP in alpha cells
Conclusions/interpretationGlucose concentrations in the hypoglycaemic range control glucagon secretion by directly modulating the cAMP concentration in alpha cells independently of paracrine influences. These findings define a novel mechanism for glucose regulation of glucagon release that underlies recovery from hypoglycaemia and may be disturbed in diabetes. (Source: Diabetologia)
Source: Diabetologia - April 5, 2019 Category: Endocrinology Source Type: research

Apolipoprotein C-III and its defined lipoprotein subspecies in relation to incident diabetes: the Multi-Ethnic Study of Atherosclerosis
AbstractAims/hypothesisApolipoprotein C-III (apoC-III) is a small proinflammatory protein that may play a key role in diabetes pathophysiology. However, prior observational studies have been limited to predominantly white populations, and the biological links between apoC-III and diabetes, particularly the role of apoC-III on specific lipoprotein particles, are not yet well understood. We therefore investigated associations of total apoC-III and apoC-III-defined lipoprotein subspecies with incident diabetes and glucose metabolism measures in a multi-ethnic cohort.MethodsFor the current analyses, baseline (2000 –2002)...
Source: Diabetologia - April 4, 2019 Category: Endocrinology Source Type: research

Impaired whole-body heat loss in type 1 diabetes during exercise in the heat: a cause for concern?
(Source: Diabetologia)
Source: Diabetologia - April 2, 2019 Category: Endocrinology Source Type: research

Canagliflozin should be prescribed with caution to individuals with type 2 diabetes and high risk of amputation
(Source: Diabetologia)
Source: Diabetologia - April 2, 2019 Category: Endocrinology Source Type: research

Beta cells in type 1 diabetes: mass and function; sleeping or dead?
AbstractHistological analysis of donor pancreases coupled with measurement of serum C-peptide in clinical cohorts has challenged the idea that all beta cells are eventually destroyed in type 1 diabetes. These findings have raised a number of questions regarding how the remaining beta cells have escaped immune destruction, whether pools of ‘sleeping’ or dysfunctional beta cells could be rejuvenated and whether there is potential for new growth of beta cells. In this Review, we describe histological and in vivo evidence of persistent beta cells in type 1 diabetes and discuss the limitations of current methods to ...
Source: Diabetologia - March 7, 2019 Category: Endocrinology Source Type: research

Metabolic health in normal-weight and obese individuals
AbstractCardiovascular complications are commonly associated with obesity. However, a subgroup of obese individuals may not be at an increased risk for cardiovascular complications; these individuals are said to have metabolically healthy obesity (MHO). In contrast, metabolically unhealthy individuals are at high risk of cardiovascular disease (CVD), irrespective of BMI; thus, this group can include individuals within the normal weight category (BMI 18.5 –24.9 kg/m2). This review provides a summary of prospective studies on MHO and metabolically unhealthy normal-weight (MUHNW) phenotypes. Notably, there is ongoi...
Source: Diabetologia - March 7, 2019 Category: Endocrinology Source Type: research