{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:34:25Z","timestamp":1783488865147,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Achieving rapid glycemic stabilization is a critical goal in the inpatient management of type 2 diabetes mellitus(T2DM). This study aimed to develop and validate a nomogram incorporating the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and key clinical parameters to predict the time to glycemic stability in hospitalized T2DM patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 356 hospitalized T2DM patients. Baseline demographic, clinical, and laboratory data, including the HALP score, were collected. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent predictors for the time to glycemic stability. The model\u2019s discriminative ability was assessed using the concordance index, and its calibration was evaluated with calibration curves. Decision curve analysis (DCA) was used to estimate clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multivariate Cox regression analysis identified older age, lower hemoglobin level, higher hemoglobin A1c (HbA1c), and a lower HALP score as independent risk factors associated with a longer time to glycemic stability. These four variables were integrated into a prognostic nomogram, which demonstrated good predictive accuracy, with a C-index of 0.81(95% CI:0.78 \u2013 0.84) in the training cohort. The calibration curves showed satisfactory agreement between predicted and observed probabilities. Decision curve analysis (DCA) indicated favorable clinical net benefit across a reasonable range of threshold probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We developed and validated a practical nomogram that effectively predicts the time to glycemic stability in hospitalized T2DM patients, that may assist clinicians in early identification of patients at risk for delayed stabilization, thereby facilitating personalized management strategies and optimizing inpatient diabetes care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1790538","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:20:42Z","timestamp":1776140442000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A novel nomogram based on HALP score for predicting time to glycemic stability in hospitalized type 2 diabetes patients"],"prefix":"10.3389","volume":"17","author":[{"given":"Ying","family":"Ke","sequence":"first","affiliation":[{"name":"Department of Urology, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyuan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Endocrine, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Development Planning and Quality Management Department, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Discipline Construction and Research Management Department, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuicui","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Endocrine, the Second Affiliated Hospital of Dalian Medical University","place":["Dalian, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2024.03.037","article-title":"Effect of glycemic variability on infectious outcomes in critically ill burn patients","volume":"50","author":"Hoang","year":"2024","journal-title":"Burns: J Int Soc For Burn Injuries"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003811","article-title":"Hyperglycemia predicts poststroke infections in acute ischemic stroke","volume":"88","author":"Zonneveld","year":"2017","journal-title":"Neurology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2024.101067","article-title":"Real-time continuous glucose monitoring-guided glucose management in inpatients with diabetes receiving short-term continuous subcutaneous insulin infusion: a randomized clinical trial","volume":"48","author":"Wang","year":"2024","journal-title":"Lancet Regional Health Western Pacific"},{"key":"B4","doi-asserted-by":"publisher","first-page":"95","DOI":"10.4137\/BMI.S38440","article-title":"Significance of HbA1c test in diagnosis and prognosis of diabetic patients","volume":"11","author":"Sherwani","year":"2016","journal-title":"biomark Insights"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4274\/cjms.2023.2022-60","article-title":"The reciprocal relationship between inflammation and diabetes: importance of medical nutrition therapy","author":"Hoca","year":"2023","journal-title":"Cyprus J Med Sci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.15420\/ecr.2018.33.1","article-title":"The role of inflammation in diabetes: current concepts and future perspectives","volume":"14","author":"Tsalamandris","year":"2019","journal-title":"Eur Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1186\/s12889-025-22632-4","article-title":"Temporal relationship between chronic inflammation and insulin resistance and their combined cumulative effect on cancer risk: a longitudinal cohort study","volume":"25","author":"Zheng","year":"2025","journal-title":"BMC Public Health"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2147\/JHC.S411521","article-title":"Prognostic significance of hemoglobin, albumin, lymphocyte and platelet (HALP) score in hepatocellular carcinoma","volume":"10","author":"Zhou","year":"2023","journal-title":"J Hepatocellular Carcinoma"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-024-03702-2","article-title":"The HALP score as a prognostic factor in metastatic biliary cancer","volume":"27","author":"Seven","year":"2025","journal-title":"Clin Transl Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4324635","article-title":"HALP index prognostic significance for colon cancer patients in a hispanic-based population","volume":"2022","author":"Calderillo Ruiz","year":"2022","journal-title":"J Clin Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2022.109496","article-title":"Hemoglobin, albumin, lymphocyte, and platelet (HALP) score and cancer prognosis: a systematic review and meta-analysis of 13,110 patients","volume":"114","author":"Xu","year":"2023","journal-title":"Int Immunopharmacol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.28367","article-title":"What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP\u2019s prognostic ability in different cancer types","volume":"14","author":"Farag","year":"2023","journal-title":"Oncotarget"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/medicina62010016","article-title":"Predicting contrast-induced nephropathy in NSTEMI: the role of the HALP score","volume":"62","author":"Akdeniz","year":"2025","journal-title":"Medicina"},{"key":"B14","doi-asserted-by":"publisher","first-page":"13843","DOI":"10.1038\/s41598-024-64166-6","article-title":"HALP score as a novel prognostic factor for patients with myelodysplastic syndromes","volume":"14","author":"Gursoy","year":"2024","journal-title":"Sci Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1186\/s12872-025-04791-9","article-title":"Association between hemoglobin-albumin-lymphocyte-platelet score and all-cause or cardiovascular mortality in patients with diabetes or prediabetes: mediated effects of renal function","volume":"25","author":"Zhao","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2147\/ITT.S499605","article-title":"Interplay between insulin resistance and immune dysregulation in type 2 diabetes mellitus: implications for therapeutic interventions","volume":"14","author":"Berbudi","year":"2025","journal-title":"ImmunoTargets Ther"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1356929","article-title":"The L-shape relationship between hemoglobin, albumin, lymphocyte, platelet score and the risk of diabetic retinopathy in the US population","volume":"15","author":"Ding","year":"2024","journal-title":"Front Endocrinol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/s0197-2456(00)00104-5","article-title":"Sample-size calculations for the cox proportional hazards regression model with nonbinary covariates","volume":"21","author":"Hsieh","year":"2000","journal-title":"Controlled Clin Trials"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.18632\/aging.202593","article-title":"\u03b2 cell aging and age-related diabetes","volume":"13","author":"Zhu","year":"2021","journal-title":"Aging"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0299","article-title":"Polypharmacy in the aging patient: a review of glycemic control in older adults with type 2 diabetes","volume":"315","author":"Lipska","year":"2016","journal-title":"JAMA"},{"key":"B21","doi-asserted-by":"publisher","first-page":"13264","DOI":"10.1038\/s41598-021-92630-0","article-title":"Advanced glycation end products and their receptors in serum of patients with type 2 diabetes","volume":"11","author":"Indyk","year":"2021","journal-title":"Sci Rep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-017-0805-4","article-title":"Impact of glycated hemoglobin (HbA1c) on identifying insulin resistance among apparently healthy individuals","volume":"25","author":"Saha","year":"2017","journal-title":"J Public Health"},{"key":"B23","doi-asserted-by":"publisher","first-page":"498","DOI":"10.3760\/cma.j.cn112338-20231009-00210","article-title":"Associations of onset age, diabetes duration and glycated hemoglobin level with ischemic stroke risk in type 2 diabetes patients: a prospective cohort study","volume":"45","author":"Fan","year":"2024","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1149239","article-title":"The crucial role and mechanism of insulin resistance in metabolic disease","volume":"14","author":"Zhao","year":"2023","journal-title":"Front Endocrinol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1530\/JOE-13-0584","article-title":"Decoding insulin resistance and metabolic syndrome for promising therapeutic intervention","volume":"220","author":"Guo","year":"2014","journal-title":"J Endocrinol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.06.002","article-title":"Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage","volume":"41","author":"Di Napoli","year":"2017","journal-title":"J Crit Care"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v14.i2.98791","article-title":"Why should lymphocytes immune profile matter in sepsis","volume":"14","author":"Nedel","year":"2025","journal-title":"World J Crit Care Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22084152","article-title":"Lymphopenia, lymphopenia-induced proliferation, and autoimmunity","volume":"22","author":"Sheu","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B29","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1186\/s12933-018-0763-3","article-title":"Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies","volume":"17","author":"Kaur","year":"2018","journal-title":"Cardiovasc Diabetol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s11010-022-04587-x","article-title":"Impairment of insulin signaling pathway PI3K\/akt\/mTOR and insulin resistance induced AGEs on diabetes mellitus and neurodegenerative diseases: a perspective review","volume":"478","author":"Ramasubbu","year":"2023","journal-title":"Mol Cell Biochem"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1790538\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:20:43Z","timestamp":1776140443000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1790538\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":30,"alternative-id":["10.3389\/fendo.2026.1790538"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1790538","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"article-number":"1790538"}}