{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:26:13Z","timestamp":1793157973799,"version":"4.5.0"},"reference-count":49,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K15397"],"award-info":[{"award-number":["23K15397"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22K11729"],"award-info":[{"award-number":["22K11729"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Hyperglucagonemia contributes to disturbances in glucose metabolism. Data-driven diabetes clustering reflects risk of diabetic complications better than classical classification, type 1 diabetes (T1D) vs type 2 diabetes (T2D); however, the pathophysiological features have not been clarified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the distribution of plasma glucagon levels among clustering-based diabetes subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 546 Japanese participants with T1D or T2D were categorized into 5 diabetes subtypes. Plasma glucagon levels were compared across subtypes, and factors associated with hyperglucagonemia were evaluated using logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Plasma glucagon levels differed significantly among diabetes subtypes. Among the 5 subtypes, plasma glucagon levels and the frequency of hyperglucagonemia were highest in the severe insulin-resistant diabetes (SIRD) subtype (45.6%). The SIRD subtype was an independent risk factor for hyperglucagonemia (adjusted odds ratio 2.17, 95% CI 1.03-4.54, P = .041), even after adjusting for other risk factors, such as body mass index, glycated hemoglobin (HbA1c), and metabolic dysfunction\u2013associated steatotic liver disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The distribution of plasma glucagon levels differed among the clustering-based diabetes subtypes. SIRD is a subtype of diabetes with a hyperglucagonemic phenotype. Elucidating the reason for hyperglucagonemia in SIRD may help to clarify the mechanisms underlying the unfavorable clinical phenotype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf654","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T13:05:05Z","timestamp":1765458305000},"page":"e1662-e1671","source":"Crossref","is-referenced-by-count":2,"title":["Unequal distribution of plasma glucagon levels among clustering-based diabetes subtypes: a Japanese cohort"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4576-8032","authenticated-orcid":false,"given":"Hayato","family":"Tanabe","sequence":"first","affiliation":[{"name":"Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine , Fukushima 960-1295 ,","place":["Japan"]},{"name":"Department of Diabetes, Endocrinology, Metabolism, and General Internal Medicine, Fukushima Medical University School of Medicine , Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Shimajiri","sequence":"additional","affiliation":[{"name":"Shimajiri Kinsermae Diabetes Care Clinic , Okinawa 901-2126 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Shiroma","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine , Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritake","family":"Higa","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Lifestyle-Related Disease Center, Tomishiro Central Hospital , Okinawa 901-0243 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Masuzaki","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), University of the Ryukyus , Okinawa 901-2725 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7835-7665","authenticated-orcid":false,"given":"Michio","family":"Shimabukuro","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine , Fukushima 960-1295 ,","place":["Japan"]},{"name":"Department of Diabetes, Endocrinology, Metabolism, and General Internal Medicine, Fukushima Medical University School of Medicine , Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,12,13]]},"reference":[{"issue":"3","key":"2026051819575431200_dgaf654-B1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJM197007162830301","article-title":"Abnormal alpha-cell function in diabetes. 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