To synthesize contemporary evidence on body mass index (BMI) variability as a determinant of cardiovascular risk, integrate mechanistic insights, and clarify its clinical relevance in individuals with and without diabetes. Large cohort studies demonstrate that greater BMI or weight variability is associated with increased risks of all-cause mortality, atherosclerotic cardiovascular disease, heart failure and atrial fibrillation, independent of mean BMI. Mechanistic evidence to explain the observed association implicates adipose tissue dysfunction, ectopic fat deposition, metabolic instability, systemic inflammation, and autonomic imbalance. Diabetes may amplify these pathways through impaired metabolic flexibility and treatment-related weight fluctuations. Evidence from diabetes-specific cohorts suggests that structured, intentional weight loss may attenuate the adverse associations seen with unstructured weight cycling. BMI variability is an emerging marker of cardiometabolic instability with implications for cardiovascular risk, particularly in diabetes. Defining actionable thresholds and determining whether stabilizing weight improves outcomes are key future research priorities.
This systematic review sought to synthetize recent studies on psychological interventions aiming to address parental psychosocial factors in families of children and adolescents with Type 1 Diabetes (T1D). Particularly, its purpose was to characterize intervention designs, frameworks, and delivery modalities, as well as to examine their findings on both parental psychosocial and youth glycemic outcomes. Twenty-six manuscripts from 2019 to 2025 were selected, including randomized controlled trials, quasi-experimental designs, pilot, feasibility, and protocol studies. Most interventions were grounded in cognitive-behavioral frameworks and implemented through a range of diverse delivery formats. Overall, the available evidence indicates that the interventions are associated with improvements across a range of parental psychosocial factors (e.g., diabetes distress, depressive and anxiety symptoms, fear of hypoglycemia, and quality of life), while findings regarding glycemic outcomes were heterogeneous across studies. Interventions targeting parents of youth with T1D appear effective in enhancing psychosocial adjustment. The diversity of study designs, theoretical frameworks, and intervention approaches reflects both heterogeneity and a robust scientific evidence base, with potential for adaptation and replication across different contexts.
Diabetes and suicide are intersecting public health concerns, yet evidence at this intersection remains sparse for Black males and especially Black sexual minority males (SMM). This focused narrative review synthesizes direct and adjacent evidence, with emphasis on diabetes-specific disparities, intersectional stress processes, and primary care implications. The diabetes-suicide literature is heterogeneous, but consistently identifies depression, diabetes distress, treatment burden, complications, and access to insulin or other medications as clinically relevant pathways. For Black males, structural racism, economic inequity, health care discrimination, and constrained access to high-quality diabetes and mental health care may intensify these burdens. The most directly relevant study identified found more lifetime suicide attempts among African American adults with type 1 diabetes than controls, but did not report male-specific estimates. We identified no study estimating diabetes-related suicidal thoughts or behaviors specifically among Black SMM. Common tools such as the Patient Health Questionnaire-9, Diabetes Distress Scale, and Columbia-Suicide Severity Rating Scale have broad clinical support but have not been specifically validated in Black males with diabetes or Black SMM. Common tools such as the Patient Health Questionnaire-9, Diabetes Distress Scale, and Columbia-Suicide Severity Rating Scale have broad clinical support, but the literature identified in this review did not establish their population-specific validity among Black males with diabetes, including Black SMM. The central finding is an evidence gap, not proof of a multiplicative risk effect. Primary care clinicians should use culturally responsive psychosocial inquiry, direct suicide assessment when indicated, collaborative safety planning, and integrated behavioral health care while avoiding assumptions that screening tools perform equivalently across populations. Prospective, disaggregated research and population-specific measurement studies are urgently needed.
Youth with type 1 diabetes face demanding daily self-management requirements. Mobile health interventions are a promising approach for supporting diabetes self-management both within clinical care and in everyday contexts. This review synthesizes recent evidence published between 2018 and 2024 on mobile health interventions designed to support self-management in children and adolescents with type 1 diabetes. Forty-four studies met inclusion criteria. Most were early-phase evaluations emphasizing feasibility, usability, and engagement. Across modalities, mHealth interventions were most successful at lowering hemoglobin A1c when they provided real-time, actionable support during insulin dosing or carbohydrate estimation. Engagement trajectory emerged as an important determinant of clinical benefit, suggesting that initial usability alone are insufficient to produce meaningful clinical impact. Mobile health interventions for youth with type 1 diabetes are feasible, acceptable, and effective for improving self-management processes and psychosocial outcomes. Glycemic improvements occur selectively when interventions provide point-of-need decision support and when engagement is sustained. Future research should prioritize mechanisms of action, strategies to support long-term engagement, and rigorous effectiveness-implementation trials to support scalable clinical impact.
This review will summarize the role of the hormone, oxytocin (OT), in the control of energy balance and glucose homeostasis in pre-clinical and clinical models and the role of sex in contributing to these effects. OT reduces intake of chow and highly palatable foods, including sucrose, high fat diet, and chocolate cookies, suggesting that it suppresses homeostatic and hedonic feeding. Chronic administration reduces body weight in diet-induced obese (DIO) rodent models. These effects occur through a selective reduction of fat mass while sparing lean mass. While OT has been found to elicit modest weight loss in a translational nonhuman primate (NHP) model, the effects of intranasal treatment of OT in humans with obesity have been mixed, highlighting the need to optimize dose, dose frequency and duration of administration and the need to develop longer-lasting OT analogs to increase compliance and to minimize off-target effects.
