Approximately 25 % of diabetic patients develop diabetic foot ulcers (DFUs), significantly increasing morbidity, mortality, and healthcare costs. Effective control and prevention are crucial. This study aims to identify easily measurable parameters for predicting DFU risk by assessing the correlation between Phase Angle (PA) and the Triglyceride-Glucose (TyG) index with DFU risk. A comparative case-control study was conducted at the General Hospital of Elche from March to June 2023 with 70 participants (33 with diabetes, 37 without). Cases had diabetes for over five years and a diabetic foot risk grade of 0, 1, or 2 (IWGDF 2019). Exclusion criteria included inability to walk, prior use of orthoses, and severe complications like edema or wounds. Predictive variables were PA, TyG index, body composition, and biochemical markers. Statistical analyses included Pearson/Spearman tests for correlations, Student's t-test/Mann-Whitney test for group comparisons, and ANOVA/Kruskal-Wallis tests for normally and non-normally distributed variables. PAand TyG index were strongly linked to diabetic foot risk, supporting their potential as biomarkers. Significant relationships with other relevant biomarkers were also confirmed. PA and TyG index are valuable, easily measurable biomarkers for assessing diabetic foot risk, and can be monitored in primary care settings. Implementing these biomarkers in routine practice could enhance the management of diabetic complications, particularly in resource-limited settings, by enabling early detection and intervention, thus improving patient outcomes and reducing the burden of advanced complications.

Even though HbA1c can be obtained easily and accurately by blood test, the cost may limit its availability for some patients and their proper follow-up. The triglyceride-glucose index has been shown to have an association with HbA1c in other populations, but it hasn't been studied in adolescents with T1DM yet. The aim of this study is to assess the association of TyG index with glycaemic control in adolescents with T1DM. This cross-sectional study included a sample of 36 adolescents (50% female) from the paediatric unit of the San Juan Hospital in Alicante (Spain). Data on sociodemographics, growth parameters, glycaemic control, and blood tests results were collected after routine visits. A higher TyG index was statistically associated with a higher BMI, percentile and z-score, a higher triglyceride, HbA1c and glucose levels and with the triglycerides/HDL, the total cholesterol/HDL, the TyG-BMI and the TyG-waist circumference indexes. The TyG index is a simple and non-invasive biomarker that could serve as a valuable adjunct to HbA1c monitoring in adolescents with T1DM. It may have a potential utility as a screening tool for early identification of patients at risk for developing metabolic complications such as insulin resistance and dyslipidemia.

Context: Young people with type 1 diabetes mellitus experience unique challenges, including physical and psychological changes, altered nutritional needs, and the risk of weight fluctuations. Psychological distress, a frequently overlooked factor in routine clinical practice, is a key variable, as it may be both a consequence of and a contributing factor to difficulties with dietary-insulin treatment in this population. It could contribute to the development of disturbed eating behaviors and more severe mental health conditions, such as eating disorders. Objective: The aim of the present systematic review was to study the relationship between the presence of psychological distress and disturbed eating behaviors in young people with type 1 diabetes mellitus. Data Sources: A systematic search was performed in the PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library databases for articles meeting the inclusion criteria as at October 2024. Data Extraction: Ten observational studies analysing the relationship between psychological distress and disordered eating behavior were included. Risk of bias was assessed using the STROBE and the Newcastle–Ottawa checklists. Data Analysis: Initially, 366 articles were identified. Of these, 10 articles were eligible for the review (2420 participants). Psychological distress was found to have a robust association with disturbed eating behaviors in all studies. Most of them found a strong association between these 2 variables and HbA1c and that women had higher levels of psychological distress and more disordered eating behaviors compared with men. Conclusion: Psychological distress may contribute to the onset and persistence of disordered eating behaviors and eating disorders in this population. This finding underscores the importance of a comprehensive approach to type 1 diabetes mellitus clinical management, and the need for addressing both psychological and behavioral factors. Early identification and intervention for psychological distress and disordered eating behaviors can positively impact HbA1c and the overall well-being of these patients, particularly women.

Purpose: Traditional markers such as HbA1c and BMI are commonly used to assess metabolic risk in adolescents with type 1 diabetes mellitus (T1DM), but novel biomarkers like the triglyceride-glucose (TyG) index and phase angle (PA) may provide a more comprehensive evaluation of metabolic risk. However, their potential role in this population remains unclear. We aimed (1) to evaluate the association of the TyG index and PA with glycemic control, cardiovascular risk and body composition in adolescents with T1DM, and (2) to determine optimal cut-off points for these biomarkers to predict metabolic risk. Methods: Seventy-three adolescents (46.6% female, 10–19 years) with T1DM from two hospitals were included in this cross-sectional study. Sociodemographic, bioelectrical impedance (BIA) and clinical data were collected during routine visits. The TyG index was calculated from fasting triglyceride and glucose levels, and PA was measured via BIA. Correlations were analyzed using Pearson or Spearman coefficients, and ROC curve analyses were used to determine optimal cut-off points. Results: PA correlated positively with skeletal muscle and fat-free mass and inversely with cardiovascular risk indicators. TyG was strongly associated with adiposity, glycemic variability and cardiovascular risk markers. A preliminary TyG threshold of 8.09 was identified, while no PA cut-off could be established. Conclusions: PA and the TyG index are promising, non-invasive biomarkers that complement traditional measures in assessing metabolic risk in adolescents with T1DM. Integrating these biomarkers into routine evaluation may enhance early risk detection and support holistic management in this population. Trial registration number: NCT07021326.

Background/Objectives: Family-related factors are central to type 1 diabetes (T1D) management during childhood and adolescence. This systematic review aimed to synthesise the available evidence on the associations between parental feeding practices, child eating and mealtime behaviours, and glycaemic, nutritional and other diabetes-related outcomes in children and adolescents with T1D. Methods: This systematic review was conducted and reported in accordance with the PRISMA 2020 statement and prospectively registered in PROSPERO (CRD420261291514). PubMed/MEDLINE, Scopus, and Web of Science were searched without publication date restrictions. Observational studies including children and adolescents aged 0–18 years with T1D and examining parental feeding practices or child eating/mealtime behaviours in relation to diabetes-related outcomes were eligible. Family mealtime functioning was considered as a secondary construct when examined within otherwise eligible feeding- or mealtime-focused studies. Study quality and risk of bias were assessed using the Newcastle–Ottawa Scale. Owing to substantial heterogeneity in study populations, constructs, assessment instruments and outcomes, findings were synthesised narratively. Results: Eleven reports representing nine unique studies were included. Most studies were cross-sectional and involved predominantly preschool and younger school-aged children, with limited representation of adolescents. Associations between feeding and mealtime-related factors and diabetes-related outcomes varied across studies and constructs. Greater child mealtime problems and specific disruptive mealtime behaviours were associated with higher HbA1c or less favourable glucose-related measures in some analyses, while aspects of family mealtime functioning were associated with dietary adherence or glucose measurements outside the target range. Parental feeding practices, including restriction and pressure to eat, showed inconsistent or null associations with glycaemic outcomes. Associations were also reported with diet quality, carbohydrate intake and mealtime behaviours, although effect direction and magnitude varied, and null findings were common. Evidence from continuous glucose monitoring-derived outcomes was limited. Conclusions: Parental feeding practices and child mealtime behaviours may be associated with glycaemic, dietary and behavioural outcomes in paediatric T1D, while family mealtime functioning emerged as a relevant secondary contextual construct. However, the available evidence is heterogeneous and predominantly cross-sectional. These constructs should not be considered interchangeable dimensions of parental control, and current evidence does not establish directionality or causality, nor demonstrate that modifying feeding or mealtime practices improves glycaemic outcomes. Further longitudinal and intervention studies using clearly defined constructs, developmentally diverse samples, and objective glycaemic measures are needed.

Background/Objectives: Adolescents with type 1 diabetes mellitus (T1DM) are particularly vulnerable to psychological distress, disordered-eating (DE) risk and negative self-perceived health status (SPHS), which may compromise metabolic control and self-care. Although these factors have been studied individually, the usefulness of brief and clinically feasible screening tools to detect these dimensions remains underexplored. This study aimed to: (1) examine associations between distress, DE risk and SPHS; (2) explore their relationships with glycemic control, clinical profile and self-care; and (3) assess the influence of age and diabetes duration on these outcomes. Methods: A cross-sectional study was conducted in 37 adolescents with T1DM in Spain. Sociodemographic, anthropometric and clinical variables were obtained from medical records. Distress, DE risk and self-care were assessed using validated questionnaires, while SPHS was measured using single-item question. Pearson and Spearman correlations were performed. Results: Distress was present in 48.6% of participants and DE risk in 29.7%, while 67.6% reported positive SPHS. Distress correlated with higher HbA1c and lower TIR. DE risk correlated with BMI. Lower SPHS was associated with higher HbA1c. Age and diabetes duration were associated with greater glycemic variability, and diabetes duration also correlated with higher glucose and TyG-based insulin resistance indexes. No significant associations were found for self-care behaviors. Conclusions: Distress, DE risk and SPHS, assessed through feasible screening tools, showed meaningful associations with metabolic outcomes in adolescents with T1DM. Integrating brief psychological screening tools into routine care may facilitate early identification of psychological vulnerability profiles in this population during routine practice.