Objective: To investigate the effect of acupuncture on high hemagglutination state, blood sugar raising hormone and immunocyte factor levels in type II diabetes patients. Methods: A total of 120 inpatients and outpati...Objective: To investigate the effect of acupuncture on high hemagglutination state, blood sugar raising hormone and immunocyte factor levels in type II diabetes patients. Methods: A total of 120 inpatients and outpatients were randomly divided into acupuncture plus medication group (n=52) and medication group (n=50). In addition, 18 type II diabetes patients formed acupuncture group for comparing their therapeutic effects. Main acupoints used were Pishu (BL 20), Geshu (BL 17), Yishu, Shenshu (BL 23), Zusanli (ST 36), Sanyinjiao (SP 6), etc.. combined with other acupoints according to different sydroms. These acupoints were stimulated by manipulaing the filiform needles with uniform reinforcing and reducing method for 15 min and then stimulated electrically for 15 min with an electroacupuncture therapeutic apparatus. Western medicines used were Glipizide, Dimethyldiguanide Hydrochloride, etc.. The treatment was given once daily, with 10 sessions being a therapeutic course, 2～3 courses altogether. Indexes of external thrombosis length (ETL), platelet agglutination rate (PAgR), fibrinogen (FG), activated partial thromboplastin time (APTT), fasting blood glucose (FBG), prothrombin time(PT), adrenocoticortropic hormone (ACTH), cortisol (CS), growth hormone (GH), glucagon (GL), tumor necrosis factor alpha (TNF α), interleukin 6 (IL 6), insulin (INS) and C peptide (C P) were determined using radioimmunoassay. Results: After 2～3 courses of treatment, both acupuncture group and medication plus acupuncture group could significantly improve high hemagglutination state, lower blood sugar raising hormone level, regulate immunocyte factor level and raise the sensitivity of insulin, which were apparently superior to those of medication group (P<0.05～0.01). Conclusion: Acupuncture therapy can effectively regulate plasma blood sugar raising hormone, immunocyte factor levels, increase the sensitivity of insulin to target cells, resist blood coagulation and improve microcirculation.展开更多
Background:Diabetes mellitus(DM)is a chronic illness with potentially fatal and debilitating consequences.Problems with glycemic management are a major issue that adds an added strain to public health services.Objecti...Background:Diabetes mellitus(DM)is a chronic illness with potentially fatal and debilitating consequences.Problems with glycemic management are a major issue that adds an added strain to public health services.Objectives:The purpose of this study is to evaluate the prevalence of poor glycemic control and its related variables among type 2 diabetes mellitus(T2DM)patients in southern Jordan.Methods:A cross-sectional study was carried out in the Prince Hashem bin Abdullah II Hospital in Jordan's southernmost province.For the period April–July 2024,516 individuals with T2D were enrolled.A structured questionnaire that had been pre-prepared was used to collect data.As an index of glycemic control,a glycated hemoglobin(Hb A1c)7%cut-off point was adopted.Results:Poor glycemic control was prevalent in 81.0%of T2DM individuals.Inadequate glycemic control was significantly worse in non-married patients and those with 10 or more years of diabetes duration,insulin treatment,dyslipidemia,neuropathy,cardiovascular illness,and glomerular filtration rate(GFR=60 m L/min;[P<0.05]).Moreover,dyslipidemia and insulin administration increased the likelihood of poor glycemic control(odds ratio[OR]:2 and 5,respectively)(P<0.05).Conclusions:Inadequate glycemic control was common among the current study par ticipants.To prevent disease consequences and enhance the health of patients with diabetes,health care professionals should pay special attention to related risk factors such as dyslipidemia,neuropathy,cardiovascular disease(CVD),extended illness duration,and insulin usage.展开更多
Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general ...Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.展开更多
Self-compassion is an important psychological resource that improves health-related quality of life and diabetes self-management;however,the psychological processes underlying these associations remain unclear.This st...Self-compassion is an important psychological resource that improves health-related quality of life and diabetes self-management;however,the psychological processes underlying these associations remain unclear.This study examined the roles of meaning in life and resilience in the relationship between self-compassion and both health-related quality of life and diabetes self-management.Participants were 301 individuals living with type 2 diabetes(176(58.5%)females,M age=49.69,SD=12.36)conveniently selected from two tertiary healthcare institutions in Nigeria.They completed self-report measures of self-compassion,meaning in life,resilience,health-related quality of life and diabetes selfmanagement.Multiple regression analyses indicated that self-compassion positively predicted health-related quality of life and diabetes self-management.Meaning in life and resilience independently and positively predicted health-related quality of life and diabetes self-management.Mediation analysis showed that meaning in life mediated the association between self-compassion and health-related quality of life,as well as diabetes self-management.Likewise,resilience mediated the connection between self-compassion and health-related quality of life,and diabetes self-management behaviour.Intervention for diabetes self-management should focus on promoting self-compassion,meaning in life and resilience abilities of patients,as they can potentially improve health and self-care behaviours needed for recovery.展开更多
In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing...In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.展开更多
Diabetes mellitus(DM)is a chronic disease influenced by gut microbiome disturbances.Honokiol(HON),a low oral bioavailability compound from Magnolia officinalis bark,has demonstrated potential as a treatment for DM.Thi...Diabetes mellitus(DM)is a chronic disease influenced by gut microbiome disturbances.Honokiol(HON),a low oral bioavailability compound from Magnolia officinalis bark,has demonstrated potential as a treatment for DM.This research investigates the effects of HON on gut microbiota and host metabolism to elucidate its mechanism of action in DM.After 8 weeks of intervention through fecal microbiota transplantation(FMT)or antibiotic treatment,HON improved glucose tolerance and lipid metabolism in a gut microbiota-dependent manner.Specifically,HON administration significantly increased Akkermansia muciniphila(AKK)abundance and modulated tryptophan(TRP)metabolism,as evidenced by 16S ribosomal ribonucleic acid(rRNA)gene sequencing and untargeted/targeted metabolomics analysis.Notably,research revealed that AKK metabolized TRP into tryptamine(TA)and other metabolites in vitro.Both AKK and TA activated the aryl hydrocarbon receptor(AHR)pathway,increasing circulating glucagon-like peptide-1(GLP-1)levels and ameliorating diabetes-related symptoms in DM mice.These findings indicate that HON’s hypoglycemic effect primarily stems from AHR-GLP-1 pathway activation through targeted modulation of AKK and microbial TRP metabolite TA,potentially enhancing HON’s clinical applications.展开更多
Diabetes mellitus represents a major global health issue,driving the need for noninvasive alternatives to traditional blood glucose monitoring methods.Recent advancements in wearable technology have introduced skin-in...Diabetes mellitus represents a major global health issue,driving the need for noninvasive alternatives to traditional blood glucose monitoring methods.Recent advancements in wearable technology have introduced skin-interfaced biosensors capable of analyzing sweat and skin biomarkers,providing innovative solutions for diabetes diagnosis and monitoring.This review comprehensively discusses the current developments in noninvasive wearable biosensors,emphasizing simultaneous detection of biochemical biomarkers(such as glucose,cortisol,lactate,branched-chain amino acids,and cytokines)and physiological signals(including heart rate,blood pressure,and sweat rate)for accurate,personalized diabetes management.We explore innovations in multimodal sensor design,materials science,biorecognition elements,and integration techniques,highlighting the importance of advanced data analytics,artificial intelligence-driven predictive algorithms,and closed-loop therapeutic systems.Additionally,the review addresses ongoing challenges in biomarker validation,sensor stability,user compliance,data privacy,and regulatory considerations.A holistic,multimodal approach enabled by these next-generation wearable biosensors holds significant potential for improving patient outcomes and facilitating proactive healthcare interventions in diabetes management.展开更多
Objective:To explore the clinical effect of personalized nutritional support in elderly women with gestational diabetes(GDM),and explore its impact on the incidence of maternal complications and pregnancy outcomes.Met...Objective:To explore the clinical effect of personalized nutritional support in elderly women with gestational diabetes(GDM),and explore its impact on the incidence of maternal complications and pregnancy outcomes.Methods:A total of 90 elderly pregnant women with gestational diabetes who were delivered in our hospital from January 2023 to January 2024 were selected as the research objects.They were randomly divided into an observation group and a control group,with 45 cases in each group.The control group only received routine pregnancy care and basic nutrition guidance,while the observation group received personalized nutrition support on this basis.Compare the blood glucose control,incidence of pregnancy complications,pregnancy outcomes,and neonatal outcomes between two groups of parturient.Result:After intervention,the fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)of the observation group were significantly lower than those of the control group,and the differences were statistically significant(p<0.05);The incidence of complications such as gestational hypertension syndrome,polyhydramnios,premature rupture of membranes,and postpartum hemorrhage in the observation group was significantly lower than that in the control group,and the difference was statistically significant(p<0.05);The cesarean section rate in the observation group was significantly lower than that in the control group,and the incidence of adverse neonatal outcomes such as fetal distress,macrosomia,neonatal asphyxia,and neonatal hypoglycemia in the observation group was significantly lower than that in the control group,with statistical significance(p<0.05).Conclusion:Individualized nutritional support for elderly women with gestational diabetes can effectively improve the level of maternal blood sugar control,reduce the incidence of complications during pregnancy,and improve the outcome of pregnancy and neonatal outcomes,which is of high clinical value.展开更多
Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articul...Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articular complications,while type 2 diabetes mellitus(T2DM)frequently coexists with RA and may exacerbate inflammatory and fibrotic processes.This editorial discusses the study by Sutton et al,the largest population-based analysis to date exploring the link between T2DM and ILD in patients with RA,and reflects on its mechanistic and clinical implications.In a nationwide cohort of more than 120000 hospitalized RA patients,Sutton et al demonstrated that the coexistence of T2DM nearly doubles the odds of developing ILD(odds ratio=2.02;95%confidence interval:1.84-2.22),with additional increases in pulmonary hypertension,pneumothorax,and length of stay.These findings reinforce the concept of a metabolic-pulmonary-autoimmune axis,in which chronic inflammation promotes insulin resistance and metabolic dysfunction,while hyperglycaemia and advanced glycation end-products amplify oxidative stress and fibrogenesis.This reciprocal interaction may induce a self-perpetuating cycle of“metaflammation”,fibrosis,and organ damage.Conclusion:Recognizing diabetes as a silent amplifier of RA-associated ILD redefines the interface between rheumatology,pulmonology,and endocrinology.Early detection and integrated management of metabolic and pulmonary comorbidities should be prioritized,while future studies must determine whether optimizing glycemic control can attenuate pulmonary fibrosis and improve longterm outcomes.展开更多
Objective:To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney...Objective:To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Methods:Using convenience sampling,100 elderly patients with diabetes mellitus complicated by chronic kidney disease who received treatment in the endocrinology department of a tertiary A-level hospital from May 2024 to May 2025 were selected as the study subjects.They were randomly divided into an experimental group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine health education and telephone follow-up,while the experimental group,in addition to the control group’s interventions,underwent combined exercise intervention based on the hospital-community-family model.Remote medical guidance was utilized to monitor and study the application effect of exercise intervention on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores in five dimensions of intrinsic capacity(exercise,cognition,psychology,vitality,and sensation)were measured before the intervention,at 4 weeks of intervention,and at 12 weeks of intervention for both groups.Results:Before the exercise intervention,there were no statistically significant differences(p>0.05)between the two groups in terms of fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores across five dimensions of intrinsic capacity:mobility,cognition,psychology,vitality,and sensation.After 12 weeks of intervention,the experimental group demonstrated significantly higher scores than the control group in glomerular filtration rate,6-minute walk distance,and the dimensions of mobility,cognition,and vitality within intrinsic capacity,with all differences being statistically significant(p<0.05).Conversely,the experimental group showed significantly lower scores than the control group in fasting blood glucose,2-hour postprandial blood glucose,and the psychological dimension of intrinsic capacity,with these differences also being statistically significant(p<0.05).Conclusion:Continuous nursing care utilizing telemedicine based on a hospital-community-family model combined with exercise intervention can effectively enhance exercise tolerance and intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease,thereby improving their quality of life.The effectiveness of the intervention is positively correlated with the duration of the intervention.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
Diabetic retinopathy is a prominent cause of blindness in adults,with early retinal ganglion cell loss contributing to visual dysfunction or blindness.In the brain,defects inγ-aminobutyric acid synaptic transmission ...Diabetic retinopathy is a prominent cause of blindness in adults,with early retinal ganglion cell loss contributing to visual dysfunction or blindness.In the brain,defects inγ-aminobutyric acid synaptic transmission are associated with pathophysiological and neurodegenerative disorders,whereas glucagon-like peptide-1 has demonstrated neuroprotective effects.However,it is not yet clear whether diabetes causes alterations in inhibitory input to retinal ganglion cells and whether and how glucagon-like peptide-1 protects against neurodegeneration in the diabetic retina through regulating inhibitory synaptic transmission to retinal ganglion cells.In the present study,we used the patch-clamp technique to recordγ-aminobutyric acid subtype A receptor-mediated miniature inhibitory postsynaptic currents in retinal ganglion cells from streptozotocin-induced diabetes model rats.We found that early diabetes(4 weeks of hyperglycemia)decreased the frequency of GABAergic miniature inhibitory postsynaptic currents in retinal ganglion cells without altering their amplitude,suggesting a reduction in the spontaneous release ofγ-aminobutyric acid to retinal ganglion cells.Topical administration of glucagon-like peptide-1 eyedrops over a period of 2 weeks effectively countered the hyperglycemia-induced downregulation of GABAergic mIPSC frequency,subsequently enhancing the survival of retinal ganglion cells.Concurrently,the protective effects of glucagon-like peptide-1 on retinal ganglion cells in diabetic rats were eliminated by topical administration of exendin-9-39,a specific glucagon-like peptide-1 receptor antagonist,or SR95531,a specific antagonist of theγ-aminobutyric acid subtype A receptor.Furthermore,extracellular perfusion of glucagon-like peptide-1 was found to elevate the frequencies of GABAergic miniature inhibitory postsynaptic currents in both ON-and OFF-type retinal ganglion cells.This elevation was shown to be mediated by activation of the phosphatidylinositol-phospholipase C/inositol 1,4,5-trisphosphate receptor/Ca2+/protein kinase C signaling pathway downstream of glucagon-like peptide-1 receptor activation.Moreover,multielectrode array recordings revealed that glucagon-like peptide-1 functionally augmented the photoresponses of ON-type retinal ganglion cells.Optomotor response tests demonstrated that diabetic rats exhibited reductions in visual acuity and contrast sensitivity that were significantly ameliorated by topical administration of glucagon-like peptide-1.These results suggest that glucagon-like peptide-1 facilitates the release ofγ-aminobutyric acid onto retinal ganglion cells through the activation of glucagon-like peptide-1 receptor,leading to the de-excitation of retinal ganglion cell circuits and the inhibition of excitotoxic processes associated with diabetic retinopathy.Collectively,our findings indicate that theγ-aminobutyric acid system has potential as a therapeutic target for mitigating early-stage diabetic retinopathy.Furthermore,the topical administration of glucagon-like peptide-1 eyedrops represents a non-invasive and effective treatment approach for managing early-stage diabetic retinopathy.展开更多
BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and lo...BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and long-term disease-free survival(DFS)and overall survival(OS)in patients with stage Ⅲ CC who receive curative resection remain controversial.AIM To investigate whether T2DM or glycemic control is associated with worse postoperative survival outcomes in stage Ⅲ CC.METHODS This retrospective cohort study included 278 patients aged 40-75 years who underwent surgery for stage Ⅲ CC from 2018 to 2021.Based on preoperative T2DM history,the patients were categorized into non-DM(n=160)and DM groups(n=118).The latter was further divided into well-controlled(n=73)and poorly controlled(n=45)groups depending on the status of glycemic control.DFS,OS,and CRR were compared between the groups and Cox regression analysis was used to identify risk factors.RESULTS Patients in the DM and non-DM groups demonstrated similar DFS,OS,and CRR(DFS:72.03%vs 78.75%,P=0.178;OS:81.36%vs 83.12%,P=0.638;CRR:14.41%vs 7.5%,P=0.063).Poorly controlled DM was associated with a significantly worse prognosis and higher CRR than well-controlled DM(DFS:62.22%vs 78.07%,P=0.021;OS:71.11%vs 87.67%,P=0.011;CRR:24.40%vs 8.22%,P=0.015).High preoperative fasting plasma glucose[DFS:Hazard ratio(HR)=2.684,P<0.001;OS:HR=2.105,P=0.019;CRR:HR=2.214,P=0.005]and glycosylated hemoglobin levels(DFS:HR=2.344,P=0.006;OS:HR=2.119,P=0.021;CRR:HR=2.449,P=0.009)indicated significantly poor prognosis and high CRR,while T2DM history did not(DFS:HR=1.178,P=0.327;OS:HR=0.933,P=0.739;CRR:HR=0.997,P=0.581).CONCLUSION Increased preoperative fasting plasma glucose and glycosylated hemoglobin levels,but not T2DM history,were identified as risk factors associated with poor postoperative outcomes and high CRR in patients with stage Ⅲ CC.展开更多
Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes ...Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards.Although GDM patients constitute a small proportion of the total number of diabetes cases,the incidence of GDM has risen significantly over the past decade,posing substantial risk to pregnant women and infants.Therefore,it warrants considerable attention.The pathogenesis of GDM is generally considered to resemble that of type II diabetes,though it may have distinct characteristics.Analyzing blood biochemical proteins in the context of GDM can help elucidate its pathogenesis,thereby facilitating more effective prevention and management strategies.This article reviews this critical clinical issue to enhance the medical community's sufficient understanding of GDM.展开更多
BACKGROUND Mizagliflozin(MIZ)is a specific inhibitor of sodium-glucose cotransport protein 1(SGLT1)originally developed as a medication for diabetes.AIM To explore the impact of MIZ on diabetic nephropathy(DN).METHODS...BACKGROUND Mizagliflozin(MIZ)is a specific inhibitor of sodium-glucose cotransport protein 1(SGLT1)originally developed as a medication for diabetes.AIM To explore the impact of MIZ on diabetic nephropathy(DN).METHODS Diabetic mice were created using db/db mice.They were administered either a low dose(0.5 mg/kg)or a high dose(1.0 mg/kg)of the SGLT1 inhibitor MIZ via stomach gavage for 8 weeks.Subsequently,mesangial cells(MCs)were isolated and subjected to high glucose conditions in culture to assess the effects of MIZ on DN.RESULTS The results showed that low doses of MIZ significantly reduced albuminuria to a level comparable to that achieved with high doses in db/db mice.High doses of MIZ led to a substantial increase in body weight in mice,along with decreased blood glucose levels and food intake.Moreover,the intervention with high-dose MIZ notably decreased the expression of extracellular matrix genes,such as collagen type 1 alpha 1 mRNA levels.While the expression of SGLT1 increased after exposure to high glucose,it decreased following treatment with MIZ.Furthermore,MIZ intervention was more effective in improving lactate dehydrogenase levels in MCs induced by high glucose compared to canagliflozin.MIZ also significantly elevated levels of antioxidant enzymes superoxide dismutase,catalase,and glutathione,while reducing malondialdehyde levels.CONCLUSION These findings indicate that MIZ can ameliorate DN by inhibiting SGLT1,inflammation,and oxidative stress.展开更多
Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both r...Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management.This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023,and to forecast diabetes prevalence through 2050.Methods:We conducted a population-based study based on the nationally representative surveys,and literature reviews.Using the DisMod-MR model and Chinese-specific disease disability weights,we estimated the non-fatal burdens of diabetes,including prevalence and years lived with disability(YLDs),across sexes,age groups,and locations.The temporal trend change was measured as the average annual percent change.The effect of the human development index on burdens was assessed by applying Spearman’s rank correlation analysis.We further projected diabetes prevalence to 2050 under 2 scenarios,the natural trend and the effective intervention on body mass index(BMI).Results:In 2023,an estimated 233 million individuals in China were living with diabetes.Compared to 2005,the agestandardized rate(ASR)of prevalence has increased by nearly 50%,from 7.53%(95%CI 7.00-8.10)to 13.7%(95%CI 12.6-14.8)in 2023.The ASR of YLDs was estimated at 19.1 per 1000 population(95%CI 18.6-19.5)in 2023,compared to 10.5 per 1000 population in 2005.The ASR of prevalence and YLDs was consistently higher in males than in females.The provinces with the highest diabetes prevalence and disease burden were Beijing,Tianjin,and Shanghai.Our forecast results suggest that if existing trends continue,the prevalence of obesity will reach 29.1%(95%CI 22.2-38.2)nationally by 2050,with some provinces in the northern region observing a prevalence of over 40%.Conversely,if effective obesity interventions were implemented,the growth in diabetes prevalence could potentially be suppressed by nearly 50%.Conclusions:The health burden and economic cost associated with diabetes are profound.There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.展开更多
Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods W...Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.展开更多
Objectives Diabetes remains a major global health challenge in China.Artificial intelligence(AI)has demonstrated considerable potential in improving diabetes management.This study aimed to assess healthcare providers...Objectives Diabetes remains a major global health challenge in China.Artificial intelligence(AI)has demonstrated considerable potential in improving diabetes management.This study aimed to assess healthcare providers’perceptions regarding AI in diabetes care across China.Methods A cross-sectional survey was conducted using snowball sampling from November 12 to November 24,2024.We selected 514 physicians and nurses by a snowball sampling method from healthcare providers across 30 cities or provinces in China.The self-developed questionnaire comprised five sections with 19 questions assessing medical workers’demographic characteristics,AI-related experience and interest,awareness,attitudes,and concerns regarding AI in diabetes care.Statistical analysis was performed using t-test,analysis of variance(ANOVA),and linear regression.Results Among them,20.0%and 48.1%of respondents had participated in AI-related research and training,while 85.4%expressed moderate to high interest in AI training for diabetes care.Most respondents reported partial awareness of AI in diabetes care,and only 12.6%exhibited a comprehensive or substantial understanding.Attitudes toward AI in diabetes care were generally positive,with a mean score of 24.50±3.38.Nurses demonstrated significantly higher scores than physicians(P<0.05).Greater awareness,prior AI training experience,and higher interest in AI training in diabetes care were strongly associated with more positive attitudes(P<0.05).Key concerns regarding AI included trust issues from AI-clinician inconsistencies(77.2%),increased workload and clinical workflow disruptions(63.4%),and incomplete legal and regulatory frameworks(60.3%).Only 34.2%of respondents expressed concerns about job displacement,indicating general confidence in their professional roles.Conclusions While Chinese healthcare providers show moderate awareness of AI in diabetes care,their attitudes are generally positive,and they are considerably interested in future training.Tailored,role-specific AI training is essential for equitable and effective integration into clinical practice.Additionally,transparent,reliable,ethical AI models must be prioritized to alleviate practitioners’concerns.展开更多
Diabetes mellitus(DM)has become one of the most serious and common chronic diseases around the world,leading to various complications and a reduction in life expectancy.Increased sedentary behavior(SB)and decreased ph...Diabetes mellitus(DM)has become one of the most serious and common chronic diseases around the world,leading to various complications and a reduction in life expectancy.Increased sedentary behavior(SB)and decreased physical activity(PA)are important contributors to the rising prevalence of DM.This article reviews the research progress on the pathogenesis of DM,the effects of SB and PA on the risk of DM,aiming to explore the influence of different PA intensities,amounts,frequencies,durations and types on the incidence of DM.Research has shown that blood glucose levels tend to increase with the prolongation of SB.Within a certain range,PA intensity and PA amount are negatively correlated with the risk of DM;Performing PA for more than 3 days per week maintains normal glucose tolerance and lower blood pressure;Engaging in 150–300 min of moderate intensity exercise or 75–150 min of high-intensity exercise per week reduces the risk of DM;PA during leisure time reduces the risk of DM,while PA during work increases the risk of DM;Both aerobic training and resistance training reduce the risk of DM,and the combination of the two training methods produces better benefits;Various types of exercises,such as cycling,soccer,aerobics,yoga,tai chi,all reduce the risk of DM.In summary,prolonged SB increases the risk of DM,while appropriate PA reduces the risk of DM.As the intensity,amount,and frequency of PA increase,the effect of reducing DM risk becomes more significant.Different exercise methods have different effects on reducing DM risk.展开更多
Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene.Maturity-onset diabetes of the young(MODY)is the most common type with 14 subtypes,each linked to spe...Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene.Maturity-onset diabetes of the young(MODY)is the most common type with 14 subtypes,each linked to specific mutations affecting insulin synthesis,secretion and glucose regulation.Common traits across MODY subtypes include early-onset diabetes,a family history of autosomal dominant diabetes,lack of features of insulin resistance,and absent islet cell autoimmunity.Many cases are misdiagnosed as type 1 and type 2 diabetes mellitus.Biomarkers and scoring systems can help identify candidates for genetic testing.GCK-MODY,a common subtype,manifests as mild hyperglycemia and doesn’t require treatment except during pregnancy.In contrast,mutations in HNF4A,HNF1A,and HNF1B genes lead to progressive beta-cell failure and similar risks of complications as type 2 diabetes mellitus.Neonatal diabetes mellitus(NDM)is a rare form of monogenic diabetes that usually presents within the first six months.Half of the cases are lifelong,while others experience transient remission.Permanent NDM is most commonly due to activating mutations in genes encoding the adenosine triphosphate-sensitive potassium channel(KCNJ11 or ABCC8)and can be transitioned to sulfonylurea after confirmation of diagnosis.Thus,in many cases,monogenic diabetes offers an opportunity to provide precision treatment.The scope has broadened with next-generation sequencing(NGS)technologies,replacing older methods like Sanger sequencing.NGS can be for targeted gene panels,whole-exome sequencing(WES),or whole-genome sequencing.Targeted gene panels offer specific information efficiently,while WES provides comprehensive data but comes with bioinformatic challenges.The surge in testing has also led to an increase in variants of unknown significance(VUS).Deciding whether VUS is disease-causing or benign can be challenging.Computational models,functional studies,and clinical knowledge help to determine pathogenicity.Advances in genetic testing technologies offer hope for improved diagnosis and personalized treatment but also raise concerns about interpretation and ethics.展开更多
文摘Objective: To investigate the effect of acupuncture on high hemagglutination state, blood sugar raising hormone and immunocyte factor levels in type II diabetes patients. Methods: A total of 120 inpatients and outpatients were randomly divided into acupuncture plus medication group (n=52) and medication group (n=50). In addition, 18 type II diabetes patients formed acupuncture group for comparing their therapeutic effects. Main acupoints used were Pishu (BL 20), Geshu (BL 17), Yishu, Shenshu (BL 23), Zusanli (ST 36), Sanyinjiao (SP 6), etc.. combined with other acupoints according to different sydroms. These acupoints were stimulated by manipulaing the filiform needles with uniform reinforcing and reducing method for 15 min and then stimulated electrically for 15 min with an electroacupuncture therapeutic apparatus. Western medicines used were Glipizide, Dimethyldiguanide Hydrochloride, etc.. The treatment was given once daily, with 10 sessions being a therapeutic course, 2～3 courses altogether. Indexes of external thrombosis length (ETL), platelet agglutination rate (PAgR), fibrinogen (FG), activated partial thromboplastin time (APTT), fasting blood glucose (FBG), prothrombin time(PT), adrenocoticortropic hormone (ACTH), cortisol (CS), growth hormone (GH), glucagon (GL), tumor necrosis factor alpha (TNF α), interleukin 6 (IL 6), insulin (INS) and C peptide (C P) were determined using radioimmunoassay. Results: After 2～3 courses of treatment, both acupuncture group and medication plus acupuncture group could significantly improve high hemagglutination state, lower blood sugar raising hormone level, regulate immunocyte factor level and raise the sensitivity of insulin, which were apparently superior to those of medication group (P<0.05～0.01). Conclusion: Acupuncture therapy can effectively regulate plasma blood sugar raising hormone, immunocyte factor levels, increase the sensitivity of insulin to target cells, resist blood coagulation and improve microcirculation.
文摘Background:Diabetes mellitus(DM)is a chronic illness with potentially fatal and debilitating consequences.Problems with glycemic management are a major issue that adds an added strain to public health services.Objectives:The purpose of this study is to evaluate the prevalence of poor glycemic control and its related variables among type 2 diabetes mellitus(T2DM)patients in southern Jordan.Methods:A cross-sectional study was carried out in the Prince Hashem bin Abdullah II Hospital in Jordan's southernmost province.For the period April–July 2024,516 individuals with T2D were enrolled.A structured questionnaire that had been pre-prepared was used to collect data.As an index of glycemic control,a glycated hemoglobin(Hb A1c)7%cut-off point was adopted.Results:Poor glycemic control was prevalent in 81.0%of T2DM individuals.Inadequate glycemic control was significantly worse in non-married patients and those with 10 or more years of diabetes duration,insulin treatment,dyslipidemia,neuropathy,cardiovascular illness,and glomerular filtration rate(GFR=60 m L/min;[P<0.05]).Moreover,dyslipidemia and insulin administration increased the likelihood of poor glycemic control(odds ratio[OR]:2 and 5,respectively)(P<0.05).Conclusions:Inadequate glycemic control was common among the current study par ticipants.To prevent disease consequences and enhance the health of patients with diabetes,health care professionals should pay special attention to related risk factors such as dyslipidemia,neuropathy,cardiovascular disease(CVD),extended illness duration,and insulin usage.
文摘Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.
文摘Self-compassion is an important psychological resource that improves health-related quality of life and diabetes self-management;however,the psychological processes underlying these associations remain unclear.This study examined the roles of meaning in life and resilience in the relationship between self-compassion and both health-related quality of life and diabetes self-management.Participants were 301 individuals living with type 2 diabetes(176(58.5%)females,M age=49.69,SD=12.36)conveniently selected from two tertiary healthcare institutions in Nigeria.They completed self-report measures of self-compassion,meaning in life,resilience,health-related quality of life and diabetes selfmanagement.Multiple regression analyses indicated that self-compassion positively predicted health-related quality of life and diabetes self-management.Meaning in life and resilience independently and positively predicted health-related quality of life and diabetes self-management.Mediation analysis showed that meaning in life mediated the association between self-compassion and health-related quality of life,as well as diabetes self-management.Likewise,resilience mediated the connection between self-compassion and health-related quality of life,and diabetes self-management behaviour.Intervention for diabetes self-management should focus on promoting self-compassion,meaning in life and resilience abilities of patients,as they can potentially improve health and self-care behaviours needed for recovery.
基金supported by the Research Funds of the Center for Big Data and Population Health of IHM(grant number JKS2022015)the Key Scientific Research Fund of the Anhui Provincial Education Department(grant number2023AH050610)the Anhui Natural Science Foundation(grant number 1808085QH252)。
文摘In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.
基金supported by the National Key Research and Development Program of China (No. 2023YFC3502605)the National Natural Science Foundation of China (Nos. 82104360,82274074, and 82204598)+1 种基金Jiangsu Funding Program for Excellent Postdoctoral TalentChina Postdoctoral Science Foundation (No. 2022M713483)
文摘Diabetes mellitus(DM)is a chronic disease influenced by gut microbiome disturbances.Honokiol(HON),a low oral bioavailability compound from Magnolia officinalis bark,has demonstrated potential as a treatment for DM.This research investigates the effects of HON on gut microbiota and host metabolism to elucidate its mechanism of action in DM.After 8 weeks of intervention through fecal microbiota transplantation(FMT)or antibiotic treatment,HON improved glucose tolerance and lipid metabolism in a gut microbiota-dependent manner.Specifically,HON administration significantly increased Akkermansia muciniphila(AKK)abundance and modulated tryptophan(TRP)metabolism,as evidenced by 16S ribosomal ribonucleic acid(rRNA)gene sequencing and untargeted/targeted metabolomics analysis.Notably,research revealed that AKK metabolized TRP into tryptamine(TA)and other metabolites in vitro.Both AKK and TA activated the aryl hydrocarbon receptor(AHR)pathway,increasing circulating glucagon-like peptide-1(GLP-1)levels and ameliorating diabetes-related symptoms in DM mice.These findings indicate that HON’s hypoglycemic effect primarily stems from AHR-GLP-1 pathway activation through targeted modulation of AKK and microbial TRP metabolite TA,potentially enhancing HON’s clinical applications.
文摘Diabetes mellitus represents a major global health issue,driving the need for noninvasive alternatives to traditional blood glucose monitoring methods.Recent advancements in wearable technology have introduced skin-interfaced biosensors capable of analyzing sweat and skin biomarkers,providing innovative solutions for diabetes diagnosis and monitoring.This review comprehensively discusses the current developments in noninvasive wearable biosensors,emphasizing simultaneous detection of biochemical biomarkers(such as glucose,cortisol,lactate,branched-chain amino acids,and cytokines)and physiological signals(including heart rate,blood pressure,and sweat rate)for accurate,personalized diabetes management.We explore innovations in multimodal sensor design,materials science,biorecognition elements,and integration techniques,highlighting the importance of advanced data analytics,artificial intelligence-driven predictive algorithms,and closed-loop therapeutic systems.Additionally,the review addresses ongoing challenges in biomarker validation,sensor stability,user compliance,data privacy,and regulatory considerations.A holistic,multimodal approach enabled by these next-generation wearable biosensors holds significant potential for improving patient outcomes and facilitating proactive healthcare interventions in diabetes management.
文摘Objective:To explore the clinical effect of personalized nutritional support in elderly women with gestational diabetes(GDM),and explore its impact on the incidence of maternal complications and pregnancy outcomes.Methods:A total of 90 elderly pregnant women with gestational diabetes who were delivered in our hospital from January 2023 to January 2024 were selected as the research objects.They were randomly divided into an observation group and a control group,with 45 cases in each group.The control group only received routine pregnancy care and basic nutrition guidance,while the observation group received personalized nutrition support on this basis.Compare the blood glucose control,incidence of pregnancy complications,pregnancy outcomes,and neonatal outcomes between two groups of parturient.Result:After intervention,the fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)of the observation group were significantly lower than those of the control group,and the differences were statistically significant(p<0.05);The incidence of complications such as gestational hypertension syndrome,polyhydramnios,premature rupture of membranes,and postpartum hemorrhage in the observation group was significantly lower than that in the control group,and the difference was statistically significant(p<0.05);The cesarean section rate in the observation group was significantly lower than that in the control group,and the incidence of adverse neonatal outcomes such as fetal distress,macrosomia,neonatal asphyxia,and neonatal hypoglycemia in the observation group was significantly lower than that in the control group,with statistical significance(p<0.05).Conclusion:Individualized nutritional support for elderly women with gestational diabetes can effectively improve the level of maternal blood sugar control,reduce the incidence of complications during pregnancy,and improve the outcome of pregnancy and neonatal outcomes,which is of high clinical value.
文摘Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articular complications,while type 2 diabetes mellitus(T2DM)frequently coexists with RA and may exacerbate inflammatory and fibrotic processes.This editorial discusses the study by Sutton et al,the largest population-based analysis to date exploring the link between T2DM and ILD in patients with RA,and reflects on its mechanistic and clinical implications.In a nationwide cohort of more than 120000 hospitalized RA patients,Sutton et al demonstrated that the coexistence of T2DM nearly doubles the odds of developing ILD(odds ratio=2.02;95%confidence interval:1.84-2.22),with additional increases in pulmonary hypertension,pneumothorax,and length of stay.These findings reinforce the concept of a metabolic-pulmonary-autoimmune axis,in which chronic inflammation promotes insulin resistance and metabolic dysfunction,while hyperglycaemia and advanced glycation end-products amplify oxidative stress and fibrogenesis.This reciprocal interaction may induce a self-perpetuating cycle of“metaflammation”,fibrosis,and organ damage.Conclusion:Recognizing diabetes as a silent amplifier of RA-associated ILD redefines the interface between rheumatology,pulmonology,and endocrinology.Early detection and integrated management of metabolic and pulmonary comorbidities should be prioritized,while future studies must determine whether optimizing glycemic control can attenuate pulmonary fibrosis and improve longterm outcomes.
基金2024 Medical Science Research Project Plan of Hebei Province:Research on the Rehabilitation Effect of Combined Exercise Intervention Based on a Hospital-Community-Family Model for Elderly Patients with Chronic Diseases(Project No.:20240083)Youth Science and Technology Project of the Hebei Provincial Health Department:Research on the Standardization Level of Self-Management in Patients with Diabetic Foot and Related Factors Affecting Wound Healing(Project No.:20190002)。
文摘Objective:To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Methods:Using convenience sampling,100 elderly patients with diabetes mellitus complicated by chronic kidney disease who received treatment in the endocrinology department of a tertiary A-level hospital from May 2024 to May 2025 were selected as the study subjects.They were randomly divided into an experimental group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine health education and telephone follow-up,while the experimental group,in addition to the control group’s interventions,underwent combined exercise intervention based on the hospital-community-family model.Remote medical guidance was utilized to monitor and study the application effect of exercise intervention on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease.Fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores in five dimensions of intrinsic capacity(exercise,cognition,psychology,vitality,and sensation)were measured before the intervention,at 4 weeks of intervention,and at 12 weeks of intervention for both groups.Results:Before the exercise intervention,there were no statistically significant differences(p>0.05)between the two groups in terms of fasting blood glucose,2-hour postprandial blood glucose,glomerular filtration rate,6-minute walk distance,and scores across five dimensions of intrinsic capacity:mobility,cognition,psychology,vitality,and sensation.After 12 weeks of intervention,the experimental group demonstrated significantly higher scores than the control group in glomerular filtration rate,6-minute walk distance,and the dimensions of mobility,cognition,and vitality within intrinsic capacity,with all differences being statistically significant(p<0.05).Conversely,the experimental group showed significantly lower scores than the control group in fasting blood glucose,2-hour postprandial blood glucose,and the psychological dimension of intrinsic capacity,with these differences also being statistically significant(p<0.05).Conclusion:Continuous nursing care utilizing telemedicine based on a hospital-community-family model combined with exercise intervention can effectively enhance exercise tolerance and intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease,thereby improving their quality of life.The effectiveness of the intervention is positively correlated with the duration of the intervention.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
基金supported by the National Natural Science Foundation of China,Nos.32070989(to YMZ),31872766(to YMZ),81790640(to XLY),and 82070993(to SJW)the grant from Sanming Project of Medicine in Shenzhen,No.SZSM202011015(to XLY)。
文摘Diabetic retinopathy is a prominent cause of blindness in adults,with early retinal ganglion cell loss contributing to visual dysfunction or blindness.In the brain,defects inγ-aminobutyric acid synaptic transmission are associated with pathophysiological and neurodegenerative disorders,whereas glucagon-like peptide-1 has demonstrated neuroprotective effects.However,it is not yet clear whether diabetes causes alterations in inhibitory input to retinal ganglion cells and whether and how glucagon-like peptide-1 protects against neurodegeneration in the diabetic retina through regulating inhibitory synaptic transmission to retinal ganglion cells.In the present study,we used the patch-clamp technique to recordγ-aminobutyric acid subtype A receptor-mediated miniature inhibitory postsynaptic currents in retinal ganglion cells from streptozotocin-induced diabetes model rats.We found that early diabetes(4 weeks of hyperglycemia)decreased the frequency of GABAergic miniature inhibitory postsynaptic currents in retinal ganglion cells without altering their amplitude,suggesting a reduction in the spontaneous release ofγ-aminobutyric acid to retinal ganglion cells.Topical administration of glucagon-like peptide-1 eyedrops over a period of 2 weeks effectively countered the hyperglycemia-induced downregulation of GABAergic mIPSC frequency,subsequently enhancing the survival of retinal ganglion cells.Concurrently,the protective effects of glucagon-like peptide-1 on retinal ganglion cells in diabetic rats were eliminated by topical administration of exendin-9-39,a specific glucagon-like peptide-1 receptor antagonist,or SR95531,a specific antagonist of theγ-aminobutyric acid subtype A receptor.Furthermore,extracellular perfusion of glucagon-like peptide-1 was found to elevate the frequencies of GABAergic miniature inhibitory postsynaptic currents in both ON-and OFF-type retinal ganglion cells.This elevation was shown to be mediated by activation of the phosphatidylinositol-phospholipase C/inositol 1,4,5-trisphosphate receptor/Ca2+/protein kinase C signaling pathway downstream of glucagon-like peptide-1 receptor activation.Moreover,multielectrode array recordings revealed that glucagon-like peptide-1 functionally augmented the photoresponses of ON-type retinal ganglion cells.Optomotor response tests demonstrated that diabetic rats exhibited reductions in visual acuity and contrast sensitivity that were significantly ameliorated by topical administration of glucagon-like peptide-1.These results suggest that glucagon-like peptide-1 facilitates the release ofγ-aminobutyric acid onto retinal ganglion cells through the activation of glucagon-like peptide-1 receptor,leading to the de-excitation of retinal ganglion cell circuits and the inhibition of excitotoxic processes associated with diabetic retinopathy.Collectively,our findings indicate that theγ-aminobutyric acid system has potential as a therapeutic target for mitigating early-stage diabetic retinopathy.Furthermore,the topical administration of glucagon-like peptide-1 eyedrops represents a non-invasive and effective treatment approach for managing early-stage diabetic retinopathy.
基金Supported by the Leading Innovation Specialist Support Program of Guangdong Provincethe Science and Technology Planning Project of Ganzhou,No.202101074816the National Natural Science Foundation of China,No.82260501.
文摘BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and long-term disease-free survival(DFS)and overall survival(OS)in patients with stage Ⅲ CC who receive curative resection remain controversial.AIM To investigate whether T2DM or glycemic control is associated with worse postoperative survival outcomes in stage Ⅲ CC.METHODS This retrospective cohort study included 278 patients aged 40-75 years who underwent surgery for stage Ⅲ CC from 2018 to 2021.Based on preoperative T2DM history,the patients were categorized into non-DM(n=160)and DM groups(n=118).The latter was further divided into well-controlled(n=73)and poorly controlled(n=45)groups depending on the status of glycemic control.DFS,OS,and CRR were compared between the groups and Cox regression analysis was used to identify risk factors.RESULTS Patients in the DM and non-DM groups demonstrated similar DFS,OS,and CRR(DFS:72.03%vs 78.75%,P=0.178;OS:81.36%vs 83.12%,P=0.638;CRR:14.41%vs 7.5%,P=0.063).Poorly controlled DM was associated with a significantly worse prognosis and higher CRR than well-controlled DM(DFS:62.22%vs 78.07%,P=0.021;OS:71.11%vs 87.67%,P=0.011;CRR:24.40%vs 8.22%,P=0.015).High preoperative fasting plasma glucose[DFS:Hazard ratio(HR)=2.684,P<0.001;OS:HR=2.105,P=0.019;CRR:HR=2.214,P=0.005]and glycosylated hemoglobin levels(DFS:HR=2.344,P=0.006;OS:HR=2.119,P=0.021;CRR:HR=2.449,P=0.009)indicated significantly poor prognosis and high CRR,while T2DM history did not(DFS:HR=1.178,P=0.327;OS:HR=0.933,P=0.739;CRR:HR=0.997,P=0.581).CONCLUSION Increased preoperative fasting plasma glucose and glycosylated hemoglobin levels,but not T2DM history,were identified as risk factors associated with poor postoperative outcomes and high CRR in patients with stage Ⅲ CC.
基金Supported by National Natural Science Foundation of China,No.32060182Qiannan Prefecture Science and Technology Plan Project in China:Qiannan Kehe She Zi[2022]No.1.
文摘Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards.Although GDM patients constitute a small proportion of the total number of diabetes cases,the incidence of GDM has risen significantly over the past decade,posing substantial risk to pregnant women and infants.Therefore,it warrants considerable attention.The pathogenesis of GDM is generally considered to resemble that of type II diabetes,though it may have distinct characteristics.Analyzing blood biochemical proteins in the context of GDM can help elucidate its pathogenesis,thereby facilitating more effective prevention and management strategies.This article reviews this critical clinical issue to enhance the medical community's sufficient understanding of GDM.
文摘BACKGROUND Mizagliflozin(MIZ)is a specific inhibitor of sodium-glucose cotransport protein 1(SGLT1)originally developed as a medication for diabetes.AIM To explore the impact of MIZ on diabetic nephropathy(DN).METHODS Diabetic mice were created using db/db mice.They were administered either a low dose(0.5 mg/kg)or a high dose(1.0 mg/kg)of the SGLT1 inhibitor MIZ via stomach gavage for 8 weeks.Subsequently,mesangial cells(MCs)were isolated and subjected to high glucose conditions in culture to assess the effects of MIZ on DN.RESULTS The results showed that low doses of MIZ significantly reduced albuminuria to a level comparable to that achieved with high doses in db/db mice.High doses of MIZ led to a substantial increase in body weight in mice,along with decreased blood glucose levels and food intake.Moreover,the intervention with high-dose MIZ notably decreased the expression of extracellular matrix genes,such as collagen type 1 alpha 1 mRNA levels.While the expression of SGLT1 increased after exposure to high glucose,it decreased following treatment with MIZ.Furthermore,MIZ intervention was more effective in improving lactate dehydrogenase levels in MCs induced by high glucose compared to canagliflozin.MIZ also significantly elevated levels of antioxidant enzymes superoxide dismutase,catalase,and glutathione,while reducing malondialdehyde levels.CONCLUSION These findings indicate that MIZ can ameliorate DN by inhibiting SGLT1,inflammation,and oxidative stress.
基金supported by the National Key Research and Development Program of China(2023YFC3605000).
文摘Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management.This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023,and to forecast diabetes prevalence through 2050.Methods:We conducted a population-based study based on the nationally representative surveys,and literature reviews.Using the DisMod-MR model and Chinese-specific disease disability weights,we estimated the non-fatal burdens of diabetes,including prevalence and years lived with disability(YLDs),across sexes,age groups,and locations.The temporal trend change was measured as the average annual percent change.The effect of the human development index on burdens was assessed by applying Spearman’s rank correlation analysis.We further projected diabetes prevalence to 2050 under 2 scenarios,the natural trend and the effective intervention on body mass index(BMI).Results:In 2023,an estimated 233 million individuals in China were living with diabetes.Compared to 2005,the agestandardized rate(ASR)of prevalence has increased by nearly 50%,from 7.53%(95%CI 7.00-8.10)to 13.7%(95%CI 12.6-14.8)in 2023.The ASR of YLDs was estimated at 19.1 per 1000 population(95%CI 18.6-19.5)in 2023,compared to 10.5 per 1000 population in 2005.The ASR of prevalence and YLDs was consistently higher in males than in females.The provinces with the highest diabetes prevalence and disease burden were Beijing,Tianjin,and Shanghai.Our forecast results suggest that if existing trends continue,the prevalence of obesity will reach 29.1%(95%CI 22.2-38.2)nationally by 2050,with some provinces in the northern region observing a prevalence of over 40%.Conversely,if effective obesity interventions were implemented,the growth in diabetes prevalence could potentially be suppressed by nearly 50%.Conclusions:The health burden and economic cost associated with diabetes are profound.There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.
基金supported by the R&D project of Pazhou Lab(Huangpu)under Grant 2023K0610the National Natural Science Foundation of China(Grants 12126602)+4 种基金the National Natural Science Foundation of China(Grants 82030102)the Shenzhen Medical Research Fund(Grants C2302001)the Shenzhen Science and Technology Innovation Committee(No.ZDSYS20200810171403013)the Chinese Postdoctoral Science Foundation(No.2022M721463)the Ministry of Science and Technology of China(Grants 2022YFC3702703).
文摘Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
基金supported by the Jiangsu Provincial Department of Science and Technology Social Development Project(No.BE2020787)。
文摘Objectives Diabetes remains a major global health challenge in China.Artificial intelligence(AI)has demonstrated considerable potential in improving diabetes management.This study aimed to assess healthcare providers’perceptions regarding AI in diabetes care across China.Methods A cross-sectional survey was conducted using snowball sampling from November 12 to November 24,2024.We selected 514 physicians and nurses by a snowball sampling method from healthcare providers across 30 cities or provinces in China.The self-developed questionnaire comprised five sections with 19 questions assessing medical workers’demographic characteristics,AI-related experience and interest,awareness,attitudes,and concerns regarding AI in diabetes care.Statistical analysis was performed using t-test,analysis of variance(ANOVA),and linear regression.Results Among them,20.0%and 48.1%of respondents had participated in AI-related research and training,while 85.4%expressed moderate to high interest in AI training for diabetes care.Most respondents reported partial awareness of AI in diabetes care,and only 12.6%exhibited a comprehensive or substantial understanding.Attitudes toward AI in diabetes care were generally positive,with a mean score of 24.50±3.38.Nurses demonstrated significantly higher scores than physicians(P<0.05).Greater awareness,prior AI training experience,and higher interest in AI training in diabetes care were strongly associated with more positive attitudes(P<0.05).Key concerns regarding AI included trust issues from AI-clinician inconsistencies(77.2%),increased workload and clinical workflow disruptions(63.4%),and incomplete legal and regulatory frameworks(60.3%).Only 34.2%of respondents expressed concerns about job displacement,indicating general confidence in their professional roles.Conclusions While Chinese healthcare providers show moderate awareness of AI in diabetes care,their attitudes are generally positive,and they are considerably interested in future training.Tailored,role-specific AI training is essential for equitable and effective integration into clinical practice.Additionally,transparent,reliable,ethical AI models must be prioritized to alleviate practitioners’concerns.
基金Key Project of Undergraduate Teaching Reform Research of Shandong Normal University(No.2024ZJ12)sixth batch of"Sports and Health"special topic of Education Research of Chinese Society of Education。
文摘Diabetes mellitus(DM)has become one of the most serious and common chronic diseases around the world,leading to various complications and a reduction in life expectancy.Increased sedentary behavior(SB)and decreased physical activity(PA)are important contributors to the rising prevalence of DM.This article reviews the research progress on the pathogenesis of DM,the effects of SB and PA on the risk of DM,aiming to explore the influence of different PA intensities,amounts,frequencies,durations and types on the incidence of DM.Research has shown that blood glucose levels tend to increase with the prolongation of SB.Within a certain range,PA intensity and PA amount are negatively correlated with the risk of DM;Performing PA for more than 3 days per week maintains normal glucose tolerance and lower blood pressure;Engaging in 150–300 min of moderate intensity exercise or 75–150 min of high-intensity exercise per week reduces the risk of DM;PA during leisure time reduces the risk of DM,while PA during work increases the risk of DM;Both aerobic training and resistance training reduce the risk of DM,and the combination of the two training methods produces better benefits;Various types of exercises,such as cycling,soccer,aerobics,yoga,tai chi,all reduce the risk of DM.In summary,prolonged SB increases the risk of DM,while appropriate PA reduces the risk of DM.As the intensity,amount,and frequency of PA increase,the effect of reducing DM risk becomes more significant.Different exercise methods have different effects on reducing DM risk.
文摘Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene.Maturity-onset diabetes of the young(MODY)is the most common type with 14 subtypes,each linked to specific mutations affecting insulin synthesis,secretion and glucose regulation.Common traits across MODY subtypes include early-onset diabetes,a family history of autosomal dominant diabetes,lack of features of insulin resistance,and absent islet cell autoimmunity.Many cases are misdiagnosed as type 1 and type 2 diabetes mellitus.Biomarkers and scoring systems can help identify candidates for genetic testing.GCK-MODY,a common subtype,manifests as mild hyperglycemia and doesn’t require treatment except during pregnancy.In contrast,mutations in HNF4A,HNF1A,and HNF1B genes lead to progressive beta-cell failure and similar risks of complications as type 2 diabetes mellitus.Neonatal diabetes mellitus(NDM)is a rare form of monogenic diabetes that usually presents within the first six months.Half of the cases are lifelong,while others experience transient remission.Permanent NDM is most commonly due to activating mutations in genes encoding the adenosine triphosphate-sensitive potassium channel(KCNJ11 or ABCC8)and can be transitioned to sulfonylurea after confirmation of diagnosis.Thus,in many cases,monogenic diabetes offers an opportunity to provide precision treatment.The scope has broadened with next-generation sequencing(NGS)technologies,replacing older methods like Sanger sequencing.NGS can be for targeted gene panels,whole-exome sequencing(WES),or whole-genome sequencing.Targeted gene panels offer specific information efficiently,while WES provides comprehensive data but comes with bioinformatic challenges.The surge in testing has also led to an increase in variants of unknown significance(VUS).Deciding whether VUS is disease-causing or benign can be challenging.Computational models,functional studies,and clinical knowledge help to determine pathogenicity.Advances in genetic testing technologies offer hope for improved diagnosis and personalized treatment but also raise concerns about interpretation and ethics.
