Publication Name	World Journal of Diabetes
Manuscript ID	115771
Country	Spain

Category	Endocrinology & Metabolism
Manuscript Type	Prospective Study
Article Title	Impact of visceral adiposity on glycemic variability in insulin-treated type 2 diabetes patients undergoing hemodialysis
Manuscript Source	Unsolicited Manuscript
All Author List	Pedro Gil-Millán, Ascensión Lupiañez, Sonia Caparrós, Alicia Ribas, Shaira Martínez-Vaquera, Ángel Ortiz-Zuñiga, Cristina Hernández, Rafael Simó and Olga Simó-Servat
Funding Agency and Grant Number
Corresponding Author	Pedro Gil-Millán, MD, Department of Endocrinology, Hospital Vall d´Hebron, Paseo de la Vall d'Hebron, 119-129, Barcelona 08035, Catalonia, Spain. pedroalejandro.gil@vallhebron.cat
Key Words	Type 2 diabetes; Hemodialysis; Visceral adiposity; Continuous glucose monitoring; Time in range; Glycemic stability; Body composition; Metabolic fragility
Core Tip	We conducted a prospective study using twenty days of continuous glucose monitoring to better understand glycemic instability in insulin-treated type 2 diabetes patients undergoing hemodialysis. Our results show that low visceral fat area is a strong and independent determinant of larger fluctuations in time-in-range between dialysis and non-dialysis days. Patients with low visceral adiposity had higher mean glucose, lower time-in-range, and more pronounced post-dialysis hyperglycemia. Visceral fat was the only variable that remained significant after multivariate adjustment. These findings suggest that visceral adiposity may act as a metabolic buffer, and that patients with low visceral fat area represent a fragile phenotype who may benefit from closer monitoring and more personalized diabetes management in the hemodialysis.
Citation	Gil-Millán P, Lupiañez A, Caparrós S, Ribas A, Martínez-Vaquera S, Ortiz-Zuñiga Á, Hernández C, Simó R, Simó-Servat O. Impact of visceral adiposity on glycemic variability in insulin-treated type 2 diabetes patients undergoing hemodialysis. World J Diabetes 2026; In press

Received	2025-10-25 08:49
Peer-Review Started	2025-10-31 00:57
First Decision by Editorial Office Director	2025-11-25 07:49
Return for Revision	2025-11-25 07:49
Revised	2025-12-04 10:32
Publication Fee Transferred	2025-12-17 07:15
Second Decision by Editor	2026-01-21 02:40
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-01-28 05:38
Articles in Press	2026-01-28 05:38
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Typeset the Manuscript

ISSN	1948-9358 (online)
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