{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:47:30Z","timestamp":1792162050516,"version":"4.4.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/hypothesis<\/jats:title>\n                    <jats:p>Our aim was to describe the phenotype at diagnosis and the early therapeutic profile of newly diagnosed type 2 diabetes across two periods spanning approximately 15 years within the same integrated healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study used electronic health record data from Clalit Health Services (Haifa &amp; Western Galilee, Israel). Adults with incident type 2 diabetes in 2005\u20132008 (period 1:\n                      <jats:italic>n<\/jats:italic>\n                      =80,201) were compared with those diagnosed in 2020\u20132023 (period 2:\n                      <jats:italic>n<\/jats:italic>\n                      =101,392). Between-period differences are presented as crude estimates, with an age-stratified sensitivity analysis, and quantified using standardised mean differences (SMDs; values \u22650.20 indicate at least a small effect) alongside non-parametric and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age at diagnosis increased from 63.0 to 66.7 years between the two periods; the proportion aged \u226585 years nearly doubled (from 3.5% to 6.6%). The score for the Charlson comorbidity index increased from 4 to 6 (SMD 0.48); metabolic dysfunction-associated steatotic liver disease (MASLD) increased from 4.4% to 18.6%. HbA\n                      <jats:sub>1c<\/jats:sub>\n                      at diagnosis decreased from 56 to 53 mmol\/mol (7.3% to 7.0%); pre-diagnosis LDL-cholesterol decreased from 2.90 to 2.21 mmol\/l (SMD 0.65). Within 31\u201390 days of diagnosis, use of sodium\u2013glucose cotransporter\u00a02 (SGLT2) inhibitors increased from 0.07% to 15.0%, use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) increased from 0% to 11.1%, and sulfonylurea use decreased more than fourfold (20.8% to 4.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>The phenotype of newly diagnosed type 2 diabetes has been fundamentally restructured since 2008: patients are older with a higher comorbidity burden but present with better glycaemic and lipid management, with the latter reflecting statin therapy already established before diagnosis. MASLD has emerged as a major but largely ascertainment-driven comorbidity. The shift to SGLT2 inhibitors and GLP-1RAs alongside declining sulfonylurea use indicates displacement of glucose-centric strategies by a cardiorenal- and weight-driven paradigm. These findings indicate a need for age-appropriate management and trials enrolling very elderly patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-026-06901-4","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:09:21Z","timestamp":1792159761000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evolving phenotype of newly diagnosed type 2 diabetes: a 15-year population-based comparison"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4315-3827","authenticated-orcid":false,"given":"Dani","family":"Kirshner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-6344","authenticated-orcid":false,"given":"Michael","family":"Hauzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"6901_CR1","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","volume":"183","author":"H Sun","year":"2022","unstructured":"Sun H, Saeedi P, Karuranga S et al (2022) IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. 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Hadar and I. Dobrovinsky (Data Research Center, Carmel Hospital, Haifa, Israel) for their valuable support and assistance with data extraction. During the preparation of this manuscript, the authors utilised Claude Opus\u00a04.8 (Anthropic, San Francisco, CA, USA) solely for the purposes of language editing, reference formatting, and verifying compliance with journal submission guidelines. The authors thoroughly reviewed, critically edited and approved all AI-generated outputs. The human authors take full public responsibility for the accuracy, integrity, and originality of the final manuscript and assert that there is no uncredited or plagiarised material within this work.","order":1,"name":"Ethics","label":"Acknowledgements","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The data that support the findings of this study are held within the Clalit Health Services data warehouse and are not publicly available owing to ethical and privacy restrictions imposed by Israeli data protection legislation and the Clalit Health Services institutional review board. Reasonable requests for access to aggregate, de-identified data may be directed to the corresponding author and will be considered on a case-by-case basis subject to institutional approval.","order":2,"name":"Ethics","label":"Data availability","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Open access funding provided by Technion - Israel Institute of Technology.","order":3,"name":"Ethics","label":"Funding","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","label":"Authors\u2019 relationships and activities","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"DK and MH conceived and designed the study, and performed data extraction and curation. DK and MH provided oversight for the statistical analyses. DK and MH drafted the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version for submission. DK is the guarantor of this work and, as such, had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.","order":5,"name":"Ethics","label":"Contribution statement","group":{"name":"EthicsHeading","label":"Ethics"}}]}}