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
As natural killer(NK)cells eliminate cancer cells and virus-infected cells,as well as modulate various other medical conditions,including aging-associated conditions such as neurodegenerative disorders,understanding N...As natural killer(NK)cells eliminate cancer cells and virus-infected cells,as well as modulate various other medical conditions,including aging-associated conditions such as neurodegenerative disorders,understanding NK cell regulation is of considerable clinical importance.This article reviews the role of circadian processes(melatonin and the cortisol system),aryl hydrocarbon receptor,and vagal nerve in the modulation of NK cell function,highlighting the importance of the endogenous mitochondrial melatonergic pathway in NK cells.As circadian and exogenous melatonin increase NK cell cytotoxicity,the presence of the endogenous melatonergic pathway may be of some importance not only to NK function and immune checkpoint regulation but also from the efflux of melatonin,which decreases tumor cell survival,proliferation,and metastasis,as well as decreasing immune checkpoint ligands,such as programmed cell ligand 1(PD-L1).NK cell melatonergic pathway regulation may therefore have significant impacts not only on NK cell cytotoxicity but also on the intercellular interactions within tumors and other pathological microenvironments.As melatonin has anti-viral effects,the regulation of the NK cell melatonergic pathway can have wider impacts on how NK cells regulate viral infections,including in the course of viral-induced susceptibility to neurodegenerative conditions.Recent data indicate that the endogenous melatonergic pathway is regulated by interactions of signal transducer and activator of transcription(STAT)3 and nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB)dimer composition.As both STAT3 and NF-κB dimer composition modulate NK cells,their interaction in the modulation of the NK cell melatonergic pathway will be important to determine.This has significant future research and treatment implications,including improving the clinical efficacy of current treatment approaches such as immune checkpoint inhibition and chimeric antigen receptor(CAR)NK cell therapy,and may accelerate a means of preventing cancer.展开更多
Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve bette...Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.Methods:We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy(CCRT)or sequential chemoradiotherapy(SCRT)(Group A)and immunotherapy combined with CCRT/SCRT followed by immunotherapy(Group B),to assess the objective response rate(ORR),disease control rate(DCR),and progression-free survival(PFS).Factors affecting prognosis were also explored using Cox analysis.The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.Results:The overall ORR was 55.93%.The overall DCR was 98.31%.The DCR was 100%in Group A and 96.61%in Group B.There was no statistical difference in ORR and DCR.The overall median PFS was 9.86 months(95%CI,8.62-11.10),and the difference in median PFS between the two groups was statistically significant(8.94 vs.11.89 months,p=0.03).The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis.Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT.Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I+II+IIIA.Conclusion:We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT.Type 2 diabetes and TNM stage affect the survival prognosis.Patients with type 2 diabetes may benefit from immunotherapy combination treatments.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
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
Objective:To analyze the application value of phased nursing care in patients undergoing laser treatment for melasma.Methods:A total of 68 patients with melasma who received laser treatment at the Dermatology Departme...Objective:To analyze the application value of phased nursing care in patients undergoing laser treatment for melasma.Methods:A total of 68 patients with melasma who received laser treatment at the Dermatology Department of Yichang Central People’s Hospital from June 2023 to June 2025 were selected as the study subjects.According to differences in nursing plans,patients were randomly divided into two groups,with 34 patients in each group:the control group received routine nursing care,while the observation group received phased nursing care.The wound healing,negative emotions,and self-efficacy of the two groups before and after nursing were compared.Results:The duration of erythema in the observation group was shorter than that in the control group,and the area of pigmentation was smaller than that in the control group(p<0.05).After nursing,the SAS and SDS scores of the observation group were lower than those of the control group(p<0.05),and the GSES scores of the observation group were higher than those of the control group(p<0.05).Conclusion:Phased nursing care can significantly improve wound healing in patients undergoing laser treatment for melasma,reduce negative emotions,and enhance self-efficacy.展开更多
BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient ...BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.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
BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated...BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.展开更多
Type 2 diabetes mellitus(T2DM)significantly elevates the risk of colorectal cancer(CRC)and complicates its treatment by promoting chemoresistance.Poor glycemic control has been linked to exacerbated CRC progression an...Type 2 diabetes mellitus(T2DM)significantly elevates the risk of colorectal cancer(CRC)and complicates its treatment by promoting chemoresistance.Poor glycemic control has been linked to exacerbated CRC progression and diminished chemotherapy efficacy,impacting patient outcomes through various mechanisms such as oxidative stress,activation of metabolic pathways,and altered protein modifications that hinder apoptosis and enhance tumor survival.Clinical evidence shows that T2DM patients experience higher rates of chemoresistance and reduced disease-free survival and overall survival compared to non-diabetic patients.Specifically,those with poor glycemic control exhibit increased chemo-resistance and poorer survival metrics.Antidiabetic treatments,including metformin,acarbose,and gliclazide,show promise in improving chemotherapy response and glycemic management,potentially enhancing patient outcomes.Addressing this challenge requires a comprehensive,multidisciplinary approach involving oncologists,endocrino-logists,and surgeons to optimize patient care.Integrated strategies that prioritize glycemic control are essential for reducing chemoresistance and improving survival in CRC patients with T2DM.展开更多
Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a...Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.展开更多
This article explores the bidirectional relationship between type 2 diabetes mellitus(T2DM)and depression,focusing on their shared pathophysiological mechanisms,including immune-inflammatory responses,gut-brain axis d...This article explores the bidirectional relationship between type 2 diabetes mellitus(T2DM)and depression,focusing on their shared pathophysiological mechanisms,including immune-inflammatory responses,gut-brain axis dysregu-lation,metabolic abnormalities,and neuroendocrine modulation.Research indicates that T2DM contributes to anxiety and depression through chronic low-grade inflammation,insulin resistance,gut microbiota imbalance,and hy-peractivation of the hypothalamic-pituitary-adrenal axis.Conversely,depression may increase the risk of T2DM via lifestyle disruption,immune activation,and neurotransmitter imbalance.Additionally,metabolic pathway disturbances-such as reduced adiponectin,impaired insulin signaling,and altered amino acid me-tabolism-may influence mood regulation and cognition.The article further examines emerging therapeutic strategies targeting these shared mechanisms,including anti-inflammatory treatments,gut microbiota modulation,hypothalamic-pituitary-adrenal axis interventions,metabolic therapies(e.g.,glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors),and multidisciplinary integrative management.Emphasizing the multisystem nature of diabetes-depression comorbidity,this work highlights the importance of incorporating mental health strategies into diabetes care to optimize outcomes and enhance patient quality of life.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM),a chronic metabolic disease with a high global incidence,has become a serious public health challenge.China has the largest number of T2DM patients worldwide,imposing a signif...BACKGROUND Type 2 diabetes mellitus(T2DM),a chronic metabolic disease with a high global incidence,has become a serious public health challenge.China has the largest number of T2DM patients worldwide,imposing a significant economic burden on the healthcare system.T2DM is closely associated with insulin resistance,impaired pancreatic B cell function,and disordered glucose and lipid metabolism,which can lead to various complications,reducing patients'quality of life and increasing the risk of disability and death.Thus,finding effective preventive and intervention measures is crucial.Exercise therapy,a key part of diabetes management,has gained attention in recent years,with many studies indicating its benefits for blood glucose control and other aspects in diabetic patients.AIM To assess the effectiveness of combined resistance and aerobic exercise interventions on blood glucose control and metabolic indicators in patients with T2DM and to explore their application in diabetes management.METHODS Systematic searches were conducted using PubMed,EMBASE,Cochrane Library,and Chinese databases for relevant randomized controlled trials(RCTs).The inclusion criteria were participants aged≥18 years with T2DM and the intervention involved combined resistance and aerobic exercise for≥8 weeks.The primary outcome indicators were fasting blood glucose,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),glycated hemoglobin A1c(HbA1c),and total cholesterol(TC)levels.Data analysis was performed using RevMan software,and the interventional effects were assessed using weighted mean differences or standardized mean differences(SMD).RESULTS Six RCTs meeting the inclusion criteria were included,with a total sample size of 366 participants.The meta-analysis results showed that combined resistance and aerobic exercise significantly improved several metabolic indicators in patients with T2DM.Specific results were as follows:(1)For fasting blood glucose,combined exercise was more effective than aerobic exercise alone[SMD=1.22;95%confidence interval(95%CI):0.70,1.74;P<0.00001];(2)LDL-C levels were significantly reduced by the combined intervention(SMD=1.45;95%CI:1.18-1.72;P<0.00001);(3)The combined intervention significantly increased HDL-C levels(SMD=1.42;95%CI:0.98-1.87;P<0.00001);(4)The combined intervention significantly reduced TG levels(SMD=1.12;95%CI:0.85-1.39;P<0.00001;(5)No statistically significant difference was observed in HbA1c between the combined and the aerobic exercise group(SMD=-0.03;95%CI:-1.09 to 1.04;P<0.00001);and(6)The combined exercise intervention group significantly reduced TC levels(SMD=2.66;95%CI:1.93-3.38;P<0.00001).The subgroup analysis results suggest that the effect of exercise interventions may be influenced by various factors,including the patient's age,baseline blood glucose levels,and exercise intensity.CONCLUSION Combined resistance and aerobic exercise intervention significantly improved fasting blood glucose,LDL-C,HDL-C,TG,and TC levels in patients with T2DM,especially in terms of blood glucose control and cardiovascular risk,demonstrating better outcomes than aerobic exercise alone.展开更多
BACKGROUND Plantamajoside(PMS)has shown potential in mitigating cell damage caused by high glucose(HG)levels.Despite this,the precise therapeutic effects of PMS on type 2 diabetes mellitus(T2DM)and the underlying regu...BACKGROUND Plantamajoside(PMS)has shown potential in mitigating cell damage caused by high glucose(HG)levels.Despite this,the precise therapeutic effects of PMS on type 2 diabetes mellitus(T2DM)and the underlying regulatory mechanisms require further exploration.AIM To investigate PMS therapeutic effects on T2DM in mice and elucidate its mechanisms of action through in vivo and in vitro experiments.METHODS An in vitro damage model of MIN6 cells was established using HG and palmitic acid(PA).PMS's protective effect on cell damage was assessed.Next,transcriptomics was employed to examine how PMS treatment affects gene expression of MIN6 cells.Furthermore,the effect of PMS on protein processing in endoplasmic reticulum and apoptosis pathways was validated.A T2DM mouse model was used to validate the therapeutic effects and mechanisms of PMS in vivo.RESULTS PMS intervention ameliorated cell injury in HG+PA-induced MIN6 cell damage.Transcriptomic analysis revealed that protein processing in the endoplasmic reticulum and apoptosis pathways were enriched in cells treated with PMS,with significant downregulation of the gene Dnajc1.Further validation indicated that PMS significantly inhibited the expression of apoptosis-related factors(Bax,CytC)and endoplasmic reticulum stress(ERS)-related factors[ATF6,XBP1,Ddit3(CHOP),GRP78],while promoting the expression of Bcl-2 and Dnajc1.Additionally,the inhibitory effects of PMS on ERS and apoptosis were abolished upon Dnajc1 silencing.Furthermore,in vivo experiments demonstrated that PMS intervention effectively improved pancreatic damage,suppressed the expression of apoptosis-related factors(Bax,CytC),and ERS-related factors[ATF6,XBP1,Ddit3(CHOP),GRP78],while promoting the expression of Bcl-2 and Dnajc1 in a T2DM model mice.CONCLUSION PMS intervention could alleviate pancreatic tissue damage effectively.The mechanism of action involves Dnajc1 activation,which subsequently inhibits apoptosis and ERS,ameliorating damage to pancreaticβ-cells.展开更多
The present study investigated the potential therapeutic potential of Ficus carica polysaccharides(FCPS)in type 2 diabetic mellitus(T2DM)mice,focusing on elucidating the underlying molecular mechanisms.Network pharmac...The present study investigated the potential therapeutic potential of Ficus carica polysaccharides(FCPS)in type 2 diabetic mellitus(T2DM)mice,focusing on elucidating the underlying molecular mechanisms.Network pharmacology analysis identified 37 shared targets between FCPS and T2DM,including perixisome proliferator activated receptor alpha(PPARα),highlighting the significance of PPAR signaling pathways in FCPS-mediated T2DM treatment.The results demonstrated that FCPS treatment significantly reduced markers of glucose and lipid metabolism(fasting blood glucose(FBG),nonestesterified fatty acid(NEFA),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)),inflammatory cytokines(tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1beta(IL-1β),monocyte chemoattractant protein-1(MCP-1)),and liver damage(glutamic pyruvic transaminase(GPT)and glutamic oxaloacetic transaminase(GOT))in T2DM mice.Additionally,FCPS ameliorated hepatic lipid droplet accumulation,fatty degeneration,and hepatocyte structural abnormalities.Western blot analysis confirmed FCPS-induced upregulation of key proteins in the IRS-1/AKT/PPARαsignaling pathway,(insulin receptor substrate 1(IRS-1),phosphatidyqinositol-3 kinase(PI3K),phospho-protein kinase B(p-AKT),glucose transporter 2(GLUT2),phospho-glycogen synthase kinase 3 beta(p-GSK-3β),phospho-adenosine 5′-monophosphate-activated protein kinase alpha(p-AMPKα),peroxisome proliferator-activated receptor gamma coactivator 1 alpha(PGC-1α),PPARα,peroxisome proliferator-activated receptor gamma(PPARγ))and downregulation of GSK-3β,sterol regulatory element binding protein 1c(SREBP-1c),fatty acid synthase(FAS),and 3-hydroxy-3-methylglutaryl-coenzyme A reductase(HMGCR).16S r RNA sequencing results revealed FCPS's ability to modulate gut microbiota dysbiosis in T2DM mice by promoting beneficial bacteria(e.g.,Lactobacillus_reuteri,Candidatus_Saccharimonas)and suppressing opportunistic pathogens(e.g.,Proteobacteria,Gammaproteobacteria,Escherichia-Shigella).These findings collectively suggest that FCPS has a marked effectiveness in improving glucose and lipid metabolism,decreasing inflammatory responses,as well as modulating the gut microbiota in T2DM mice via the gut-hepatic axis,demonstrating its potential as a functional food for diabetes prevention and management.展开更多
Some research have shown that the combination of plant extracts and probiotics may be a better way to treat type 2 diabetes mellitus(T2DM)than a single intervention.However,there are still relatively few relevant repo...Some research have shown that the combination of plant extracts and probiotics may be a better way to treat type 2 diabetes mellitus(T2DM)than a single intervention.However,there are still relatively few relevant reports in this aspect.Therefore,this study aims to investigate whether the treatment of Polygonatum sibiricum saponin(PSS)and lactic acid bacteria(LAB)combination can better manage T2DM.And the anti-diabetes mechanism of the combination was studied from the perspectives of glucose metabolism,microbiome and metabolome.The results showed that PSS+LAB could better improve fasting blood glucose level,insulin sensitivity,lipid metabolism disorder,and liver function.Protein analysis showed that PSS+LAB treatment significantly increased the expression of phosphorylated-phosphatidylinositol 3 kinase(p-PI3K)/PI3K,phosphorylated-protein kinase B(p-AKT)/AKT,glucose transporter 2(GLUT2),insulin receptor substrate 2(IRS2),and glycogen synthase kinase 3β(GSK-3β)in the liver of T2DM mice,while inhibiting the expression of forkhead box protein O1(FoxO1).This combination positively regulated the composition and abundance of the gut microbiota.Metabolomic analysis showed that the combination treatment exhibited more changes in gut microbiota metabolites compared to PSS treatment alone.The alteration of gut microbiota by LAB+PSS led to significant changes in alanine,aspartate and glucose metabolism pathways.This study may provide a theoretical basis for the combined application of plant extracts and probiotics for the management of T2DM.展开更多
Cumulative studies have shown that the composition of the gut microbiome is strongly associated with the development of type 2 diabetes mellitus(T2DM).Electroacupuncture(EA)therapy has been reported to alleviate vario...Cumulative studies have shown that the composition of the gut microbiome is strongly associated with the development of type 2 diabetes mellitus(T2DM).Electroacupuncture(EA)therapy has been reported to alleviate various diseases,including T2DM,by targeting specific acupuncture points and regulating metabolic homeostasis.A recent review published in the World Journal of Diabetes detailed the role of the gut microbiome in T2DM,discussing the role of therapeutic strategies developed to alleviate T2DM and its complications based on gut microbiome in ameliorating T2DM,as well as the effects of multiple diabetes medications on gut microbiome.However,the review did not elucidate the therapeutic role of EA therapy,a common non-pharmacological intervention for T2DM.This letter complemented the effect of EA therapy on glucose metabolism by adjusting the gut microbiome composition,which reveals the underlying mechanism of glucose lowering by EA therapy and provides a scientific basis for the application of EA therapy in clinical treatment.展开更多
BACKGROUND Diabetic encephalopathy(DE)is a common and serious complication of diabetes that can cause death in many patients and significantly affects the lives of individuals and society.Multiple studies investigatin...BACKGROUND Diabetic encephalopathy(DE)is a common and serious complication of diabetes that can cause death in many patients and significantly affects the lives of individuals and society.Multiple studies investigating the pathogenesis of DE have been reported.However,few studies have focused on scientometric analysis of DE.AIM To analyze literature on DE using scientometrics to provide a comprehensive picture of research directions and progress in this field.METHODS We reviewed studies on DE or cognitive impairment published between 2004 and 2023.The latter were used to identify the most frequent keywords in the keyword analysis and explore the hotspots and trends of DE.RESULTS Scientometric analysis revealed 1308 research papers on DE,a number that increased annually over the past 20 years,and that the primary topics explored were domain distribution,knowledge structure,evolution,and emergence of research topics related to DE.The inducing factors,comorbidities,pathogenesis,treatment,and animal models of DE help clarify its occurrence,development,and treatment.An increasing number of studies on DE may be a result of the recent increase in patients with diabetes,unhealthy lifestyles,and unhealthy eating habits,which have aggravated the incidence of this disease.CONCLUSION We identified the main inducing factors and comorbidities of DE,though other complex factors undoubtedly increase social and economic burdens.These findings provide vital references for future studies.展开更多
AIM:To determine the risk factors and time to non-arteric ischemic optic neuropathy(NAION)occurrence among Thai type 2 diabetes mellitus(T2DM)patients.METHODS:A retrospective review of 266 newly diagnosed T2DM cases a...AIM:To determine the risk factors and time to non-arteric ischemic optic neuropathy(NAION)occurrence among Thai type 2 diabetes mellitus(T2DM)patients.METHODS:A retrospective review of 266 newly diagnosed T2DM cases at Rajavithi Hospital between 2007 and 2016 was conducted to determine time to occurrence of NAION and evaluate associated risk factors.RESULTS:Hypertension and dyslipidemia were the most common pre-existing vascular diseases and there was a significant male predominance in the NAION group.The mean age of the NAION group was significantly higher than that of the group without NAION.A higher proportion of subjects in the NAION group had hypertension,dyslipidemia,high diastolic blood pressure,smokers,and had a small cup-to-disc ratio(CDR).Higher levels of triglycerides and lowdensity lipoprotein-cholesterol in the group with NAION.Fiftyfive patients among 266 participants(20.68%)developed NAION during a mean follow-up time of 81.26±25.04mo.In a multivariable logistic regression analysis,dyslipidemia(OR=8.36,95%CI,3.447–20.273,P<0.001),high low density lipoprotein levels(OR=1.017,95%CI,1.004–1.029,P=0.009),and small CDR(OR=11.92,95%CI,4.477–31.741,P<0.001)were significant risk factors for NAION development.Smoking was the strongest predictive risk(OR=12.843,95%CI,3.959–41.659,P<0.001).Vascular complications of T2DM and aspirin were not associated with NAION.CONCLUSION:T2DM patients with dyslipidemia or a small CDR should be carefully followed up as they are at increased risk of developing NAION.展开更多
The glucagon receptor(GCGR)is a critical target for the treatment of metabolic disorders such as Type 2 Diabetes Mellitus(T2DM)and obesity.Activation of GCGR enhances systemic insulin sensitivity through paracrine sti...The glucagon receptor(GCGR)is a critical target for the treatment of metabolic disorders such as Type 2 Diabetes Mellitus(T2DM)and obesity.Activation of GCGR enhances systemic insulin sensitivity through paracrine stimulation of insulin secretion,presenting a promising avenue for treatment.However,the discovery of effective GCGR agonists remains a challenging and resource-intensive process,often requiring time-consuming wet-lab experiments to synthesize and screen potential compounds.Recent advances in artificial intelligence technologies have demonstrated great potential in accelerating drug discovery by streamlining screening and efficiently predicting bioactivity.In the present work,we propose DeepGCGR,a two-layer deep learning model that leverages graph convolutional networks(GCN)integrated with a multiple attention mechanism to expedite the identification of GCGR agonists.In the first layer,the model predicts the bioactivity of various compounds against GCGR,efficiently filtering large chemical libraries to identify promising candidates.In the second layer,DeepGCGR classifies high bioactive compounds based on their functional effects on GCGR signaling,identifying those with potential agonistic or antagonistic effects.Moreover,DeepGCGR was specifically applied to identify novel GCGR-regulating compounds for the treatment of T2DM from natural products derived from traditional Chinese medicine(TCM).The proposed method will not only offer an effective strategy for discovering GCGR-targeting compounds with functional activation properties but also provide new insights into the development of T2DM therapeutics.展开更多
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.
文摘As natural killer(NK)cells eliminate cancer cells and virus-infected cells,as well as modulate various other medical conditions,including aging-associated conditions such as neurodegenerative disorders,understanding NK cell regulation is of considerable clinical importance.This article reviews the role of circadian processes(melatonin and the cortisol system),aryl hydrocarbon receptor,and vagal nerve in the modulation of NK cell function,highlighting the importance of the endogenous mitochondrial melatonergic pathway in NK cells.As circadian and exogenous melatonin increase NK cell cytotoxicity,the presence of the endogenous melatonergic pathway may be of some importance not only to NK function and immune checkpoint regulation but also from the efflux of melatonin,which decreases tumor cell survival,proliferation,and metastasis,as well as decreasing immune checkpoint ligands,such as programmed cell ligand 1(PD-L1).NK cell melatonergic pathway regulation may therefore have significant impacts not only on NK cell cytotoxicity but also on the intercellular interactions within tumors and other pathological microenvironments.As melatonin has anti-viral effects,the regulation of the NK cell melatonergic pathway can have wider impacts on how NK cells regulate viral infections,including in the course of viral-induced susceptibility to neurodegenerative conditions.Recent data indicate that the endogenous melatonergic pathway is regulated by interactions of signal transducer and activator of transcription(STAT)3 and nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB)dimer composition.As both STAT3 and NF-κB dimer composition modulate NK cells,their interaction in the modulation of the NK cell melatonergic pathway will be important to determine.This has significant future research and treatment implications,including improving the clinical efficacy of current treatment approaches such as immune checkpoint inhibition and chimeric antigen receptor(CAR)NK cell therapy,and may accelerate a means of preventing cancer.
基金funded by the National Natural Science Foundation of China(grant no.82273162)the National Natural Science Foundation of China(grant no.82203272)the Science and Technology Development Foundation of Nanjing Medical University(grant NMUB20240119)。
文摘Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.Methods:We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy(CCRT)or sequential chemoradiotherapy(SCRT)(Group A)and immunotherapy combined with CCRT/SCRT followed by immunotherapy(Group B),to assess the objective response rate(ORR),disease control rate(DCR),and progression-free survival(PFS).Factors affecting prognosis were also explored using Cox analysis.The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.Results:The overall ORR was 55.93%.The overall DCR was 98.31%.The DCR was 100%in Group A and 96.61%in Group B.There was no statistical difference in ORR and DCR.The overall median PFS was 9.86 months(95%CI,8.62-11.10),and the difference in median PFS between the two groups was statistically significant(8.94 vs.11.89 months,p=0.03).The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis.Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT.Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I+II+IIIA.Conclusion:We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT.Type 2 diabetes and TNM stage affect the survival prognosis.Patients with type 2 diabetes may benefit from immunotherapy combination treatments.
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.
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.
文摘Objective:To analyze the application value of phased nursing care in patients undergoing laser treatment for melasma.Methods:A total of 68 patients with melasma who received laser treatment at the Dermatology Department of Yichang Central People’s Hospital from June 2023 to June 2025 were selected as the study subjects.According to differences in nursing plans,patients were randomly divided into two groups,with 34 patients in each group:the control group received routine nursing care,while the observation group received phased nursing care.The wound healing,negative emotions,and self-efficacy of the two groups before and after nursing were compared.Results:The duration of erythema in the observation group was shorter than that in the control group,and the area of pigmentation was smaller than that in the control group(p<0.05).After nursing,the SAS and SDS scores of the observation group were lower than those of the control group(p<0.05),and the GSES scores of the observation group were higher than those of the control group(p<0.05).Conclusion:Phased nursing care can significantly improve wound healing in patients undergoing laser treatment for melasma,reduce negative emotions,and enhance self-efficacy.
基金Supported by CAMS Innovation Fund for Medical Sciences,No.2023-I2M-C&T-B-043National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015+1 种基金CAMS Innovation Fund for Medical Sciences,No.2021-1-12M-002Beijing Municipal Natural Science Foundation,No.M22014.
文摘BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.
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.
文摘BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.
文摘Type 2 diabetes mellitus(T2DM)significantly elevates the risk of colorectal cancer(CRC)and complicates its treatment by promoting chemoresistance.Poor glycemic control has been linked to exacerbated CRC progression and diminished chemotherapy efficacy,impacting patient outcomes through various mechanisms such as oxidative stress,activation of metabolic pathways,and altered protein modifications that hinder apoptosis and enhance tumor survival.Clinical evidence shows that T2DM patients experience higher rates of chemoresistance and reduced disease-free survival and overall survival compared to non-diabetic patients.Specifically,those with poor glycemic control exhibit increased chemo-resistance and poorer survival metrics.Antidiabetic treatments,including metformin,acarbose,and gliclazide,show promise in improving chemotherapy response and glycemic management,potentially enhancing patient outcomes.Addressing this challenge requires a comprehensive,multidisciplinary approach involving oncologists,endocrino-logists,and surgeons to optimize patient care.Integrated strategies that prioritize glycemic control are essential for reducing chemoresistance and improving survival in CRC patients with T2DM.
基金supported by the 90th Anniversary of Chulalong-korn University Scholarship(Ratchadaphiseksomphot Endowment Fund)。
文摘Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.
基金Supported by the Quzhou Science and Technology Plan Project funded by the Quzhou Municipal Science and Technology Bureau,No.2022K67,No.2022K69,and No.2024K076.
文摘This article explores the bidirectional relationship between type 2 diabetes mellitus(T2DM)and depression,focusing on their shared pathophysiological mechanisms,including immune-inflammatory responses,gut-brain axis dysregu-lation,metabolic abnormalities,and neuroendocrine modulation.Research indicates that T2DM contributes to anxiety and depression through chronic low-grade inflammation,insulin resistance,gut microbiota imbalance,and hy-peractivation of the hypothalamic-pituitary-adrenal axis.Conversely,depression may increase the risk of T2DM via lifestyle disruption,immune activation,and neurotransmitter imbalance.Additionally,metabolic pathway disturbances-such as reduced adiponectin,impaired insulin signaling,and altered amino acid me-tabolism-may influence mood regulation and cognition.The article further examines emerging therapeutic strategies targeting these shared mechanisms,including anti-inflammatory treatments,gut microbiota modulation,hypothalamic-pituitary-adrenal axis interventions,metabolic therapies(e.g.,glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors),and multidisciplinary integrative management.Emphasizing the multisystem nature of diabetes-depression comorbidity,this work highlights the importance of incorporating mental health strategies into diabetes care to optimize outcomes and enhance patient quality of life.
基金Supported by Research Project of Zhejiang Provincial Science and Technology Plan for Traditional Chinese Medicine,No.2024ZL753and Research Project of Zhejiang Provincial Medical and Health Science and Technology Plan,No.2024KY1406.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM),a chronic metabolic disease with a high global incidence,has become a serious public health challenge.China has the largest number of T2DM patients worldwide,imposing a significant economic burden on the healthcare system.T2DM is closely associated with insulin resistance,impaired pancreatic B cell function,and disordered glucose and lipid metabolism,which can lead to various complications,reducing patients'quality of life and increasing the risk of disability and death.Thus,finding effective preventive and intervention measures is crucial.Exercise therapy,a key part of diabetes management,has gained attention in recent years,with many studies indicating its benefits for blood glucose control and other aspects in diabetic patients.AIM To assess the effectiveness of combined resistance and aerobic exercise interventions on blood glucose control and metabolic indicators in patients with T2DM and to explore their application in diabetes management.METHODS Systematic searches were conducted using PubMed,EMBASE,Cochrane Library,and Chinese databases for relevant randomized controlled trials(RCTs).The inclusion criteria were participants aged≥18 years with T2DM and the intervention involved combined resistance and aerobic exercise for≥8 weeks.The primary outcome indicators were fasting blood glucose,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),glycated hemoglobin A1c(HbA1c),and total cholesterol(TC)levels.Data analysis was performed using RevMan software,and the interventional effects were assessed using weighted mean differences or standardized mean differences(SMD).RESULTS Six RCTs meeting the inclusion criteria were included,with a total sample size of 366 participants.The meta-analysis results showed that combined resistance and aerobic exercise significantly improved several metabolic indicators in patients with T2DM.Specific results were as follows:(1)For fasting blood glucose,combined exercise was more effective than aerobic exercise alone[SMD=1.22;95%confidence interval(95%CI):0.70,1.74;P<0.00001];(2)LDL-C levels were significantly reduced by the combined intervention(SMD=1.45;95%CI:1.18-1.72;P<0.00001);(3)The combined intervention significantly increased HDL-C levels(SMD=1.42;95%CI:0.98-1.87;P<0.00001);(4)The combined intervention significantly reduced TG levels(SMD=1.12;95%CI:0.85-1.39;P<0.00001;(5)No statistically significant difference was observed in HbA1c between the combined and the aerobic exercise group(SMD=-0.03;95%CI:-1.09 to 1.04;P<0.00001);and(6)The combined exercise intervention group significantly reduced TC levels(SMD=2.66;95%CI:1.93-3.38;P<0.00001).The subgroup analysis results suggest that the effect of exercise interventions may be influenced by various factors,including the patient's age,baseline blood glucose levels,and exercise intensity.CONCLUSION Combined resistance and aerobic exercise intervention significantly improved fasting blood glucose,LDL-C,HDL-C,TG,and TC levels in patients with T2DM,especially in terms of blood glucose control and cardiovascular risk,demonstrating better outcomes than aerobic exercise alone.
基金Yuansong Wang National Famous Traditional Chinese Medicine Expert Heritage Studio,No.4(2022).
文摘BACKGROUND Plantamajoside(PMS)has shown potential in mitigating cell damage caused by high glucose(HG)levels.Despite this,the precise therapeutic effects of PMS on type 2 diabetes mellitus(T2DM)and the underlying regulatory mechanisms require further exploration.AIM To investigate PMS therapeutic effects on T2DM in mice and elucidate its mechanisms of action through in vivo and in vitro experiments.METHODS An in vitro damage model of MIN6 cells was established using HG and palmitic acid(PA).PMS's protective effect on cell damage was assessed.Next,transcriptomics was employed to examine how PMS treatment affects gene expression of MIN6 cells.Furthermore,the effect of PMS on protein processing in endoplasmic reticulum and apoptosis pathways was validated.A T2DM mouse model was used to validate the therapeutic effects and mechanisms of PMS in vivo.RESULTS PMS intervention ameliorated cell injury in HG+PA-induced MIN6 cell damage.Transcriptomic analysis revealed that protein processing in the endoplasmic reticulum and apoptosis pathways were enriched in cells treated with PMS,with significant downregulation of the gene Dnajc1.Further validation indicated that PMS significantly inhibited the expression of apoptosis-related factors(Bax,CytC)and endoplasmic reticulum stress(ERS)-related factors[ATF6,XBP1,Ddit3(CHOP),GRP78],while promoting the expression of Bcl-2 and Dnajc1.Additionally,the inhibitory effects of PMS on ERS and apoptosis were abolished upon Dnajc1 silencing.Furthermore,in vivo experiments demonstrated that PMS intervention effectively improved pancreatic damage,suppressed the expression of apoptosis-related factors(Bax,CytC),and ERS-related factors[ATF6,XBP1,Ddit3(CHOP),GRP78],while promoting the expression of Bcl-2 and Dnajc1 in a T2DM model mice.CONCLUSION PMS intervention could alleviate pancreatic tissue damage effectively.The mechanism of action involves Dnajc1 activation,which subsequently inhibits apoptosis and ERS,ameliorating damage to pancreaticβ-cells.
基金supported by the Open Project Fund of Key Laboratory of Xinjiang Uygur Autonomous Region(2021D04019)the Natural Science Foundation of Xinjiang Uygur Autonomous Region(2024D01C57)+1 种基金the National Natural Science Foundation of China(32460188)the Key Research and Development Program in Xinjiang Uygur Autonomous Region to Weilan Wang(2024B02025 and 2024B02025-2)。
文摘The present study investigated the potential therapeutic potential of Ficus carica polysaccharides(FCPS)in type 2 diabetic mellitus(T2DM)mice,focusing on elucidating the underlying molecular mechanisms.Network pharmacology analysis identified 37 shared targets between FCPS and T2DM,including perixisome proliferator activated receptor alpha(PPARα),highlighting the significance of PPAR signaling pathways in FCPS-mediated T2DM treatment.The results demonstrated that FCPS treatment significantly reduced markers of glucose and lipid metabolism(fasting blood glucose(FBG),nonestesterified fatty acid(NEFA),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)),inflammatory cytokines(tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1beta(IL-1β),monocyte chemoattractant protein-1(MCP-1)),and liver damage(glutamic pyruvic transaminase(GPT)and glutamic oxaloacetic transaminase(GOT))in T2DM mice.Additionally,FCPS ameliorated hepatic lipid droplet accumulation,fatty degeneration,and hepatocyte structural abnormalities.Western blot analysis confirmed FCPS-induced upregulation of key proteins in the IRS-1/AKT/PPARαsignaling pathway,(insulin receptor substrate 1(IRS-1),phosphatidyqinositol-3 kinase(PI3K),phospho-protein kinase B(p-AKT),glucose transporter 2(GLUT2),phospho-glycogen synthase kinase 3 beta(p-GSK-3β),phospho-adenosine 5′-monophosphate-activated protein kinase alpha(p-AMPKα),peroxisome proliferator-activated receptor gamma coactivator 1 alpha(PGC-1α),PPARα,peroxisome proliferator-activated receptor gamma(PPARγ))and downregulation of GSK-3β,sterol regulatory element binding protein 1c(SREBP-1c),fatty acid synthase(FAS),and 3-hydroxy-3-methylglutaryl-coenzyme A reductase(HMGCR).16S r RNA sequencing results revealed FCPS's ability to modulate gut microbiota dysbiosis in T2DM mice by promoting beneficial bacteria(e.g.,Lactobacillus_reuteri,Candidatus_Saccharimonas)and suppressing opportunistic pathogens(e.g.,Proteobacteria,Gammaproteobacteria,Escherichia-Shigella).These findings collectively suggest that FCPS has a marked effectiveness in improving glucose and lipid metabolism,decreasing inflammatory responses,as well as modulating the gut microbiota in T2DM mice via the gut-hepatic axis,demonstrating its potential as a functional food for diabetes prevention and management.
基金supported by National Natural Science Foundation of China(32000252)Natural Science Foundation of Heilongjiang Province of China(YQ2020C014,ZD2019C002)National Key Research and Development Program of China(2017YFC1601901)。
文摘Some research have shown that the combination of plant extracts and probiotics may be a better way to treat type 2 diabetes mellitus(T2DM)than a single intervention.However,there are still relatively few relevant reports in this aspect.Therefore,this study aims to investigate whether the treatment of Polygonatum sibiricum saponin(PSS)and lactic acid bacteria(LAB)combination can better manage T2DM.And the anti-diabetes mechanism of the combination was studied from the perspectives of glucose metabolism,microbiome and metabolome.The results showed that PSS+LAB could better improve fasting blood glucose level,insulin sensitivity,lipid metabolism disorder,and liver function.Protein analysis showed that PSS+LAB treatment significantly increased the expression of phosphorylated-phosphatidylinositol 3 kinase(p-PI3K)/PI3K,phosphorylated-protein kinase B(p-AKT)/AKT,glucose transporter 2(GLUT2),insulin receptor substrate 2(IRS2),and glycogen synthase kinase 3β(GSK-3β)in the liver of T2DM mice,while inhibiting the expression of forkhead box protein O1(FoxO1).This combination positively regulated the composition and abundance of the gut microbiota.Metabolomic analysis showed that the combination treatment exhibited more changes in gut microbiota metabolites compared to PSS treatment alone.The alteration of gut microbiota by LAB+PSS led to significant changes in alanine,aspartate and glucose metabolism pathways.This study may provide a theoretical basis for the combined application of plant extracts and probiotics for the management of T2DM.
文摘Cumulative studies have shown that the composition of the gut microbiome is strongly associated with the development of type 2 diabetes mellitus(T2DM).Electroacupuncture(EA)therapy has been reported to alleviate various diseases,including T2DM,by targeting specific acupuncture points and regulating metabolic homeostasis.A recent review published in the World Journal of Diabetes detailed the role of the gut microbiome in T2DM,discussing the role of therapeutic strategies developed to alleviate T2DM and its complications based on gut microbiome in ameliorating T2DM,as well as the effects of multiple diabetes medications on gut microbiome.However,the review did not elucidate the therapeutic role of EA therapy,a common non-pharmacological intervention for T2DM.This letter complemented the effect of EA therapy on glucose metabolism by adjusting the gut microbiome composition,which reveals the underlying mechanism of glucose lowering by EA therapy and provides a scientific basis for the application of EA therapy in clinical treatment.
基金Supported by the Beijing Natural Sciences Foundation No.7242240Doctoral Startup Fund,No.2024BSZR052new teachers at the Beijing University of Chinese Medicine started the funding project,No.2022-JYB-XJSJJ-021.
文摘BACKGROUND Diabetic encephalopathy(DE)is a common and serious complication of diabetes that can cause death in many patients and significantly affects the lives of individuals and society.Multiple studies investigating the pathogenesis of DE have been reported.However,few studies have focused on scientometric analysis of DE.AIM To analyze literature on DE using scientometrics to provide a comprehensive picture of research directions and progress in this field.METHODS We reviewed studies on DE or cognitive impairment published between 2004 and 2023.The latter were used to identify the most frequent keywords in the keyword analysis and explore the hotspots and trends of DE.RESULTS Scientometric analysis revealed 1308 research papers on DE,a number that increased annually over the past 20 years,and that the primary topics explored were domain distribution,knowledge structure,evolution,and emergence of research topics related to DE.The inducing factors,comorbidities,pathogenesis,treatment,and animal models of DE help clarify its occurrence,development,and treatment.An increasing number of studies on DE may be a result of the recent increase in patients with diabetes,unhealthy lifestyles,and unhealthy eating habits,which have aggravated the incidence of this disease.CONCLUSION We identified the main inducing factors and comorbidities of DE,though other complex factors undoubtedly increase social and economic burdens.These findings provide vital references for future studies.
文摘AIM:To determine the risk factors and time to non-arteric ischemic optic neuropathy(NAION)occurrence among Thai type 2 diabetes mellitus(T2DM)patients.METHODS:A retrospective review of 266 newly diagnosed T2DM cases at Rajavithi Hospital between 2007 and 2016 was conducted to determine time to occurrence of NAION and evaluate associated risk factors.RESULTS:Hypertension and dyslipidemia were the most common pre-existing vascular diseases and there was a significant male predominance in the NAION group.The mean age of the NAION group was significantly higher than that of the group without NAION.A higher proportion of subjects in the NAION group had hypertension,dyslipidemia,high diastolic blood pressure,smokers,and had a small cup-to-disc ratio(CDR).Higher levels of triglycerides and lowdensity lipoprotein-cholesterol in the group with NAION.Fiftyfive patients among 266 participants(20.68%)developed NAION during a mean follow-up time of 81.26±25.04mo.In a multivariable logistic regression analysis,dyslipidemia(OR=8.36,95%CI,3.447–20.273,P<0.001),high low density lipoprotein levels(OR=1.017,95%CI,1.004–1.029,P=0.009),and small CDR(OR=11.92,95%CI,4.477–31.741,P<0.001)were significant risk factors for NAION development.Smoking was the strongest predictive risk(OR=12.843,95%CI,3.959–41.659,P<0.001).Vascular complications of T2DM and aspirin were not associated with NAION.CONCLUSION:T2DM patients with dyslipidemia or a small CDR should be carefully followed up as they are at increased risk of developing NAION.
基金supported by Natural Science Foundation of Sichuan(No.2024ZDZX0019)National Natural Science Foundation of China(No.32200576)+1 种基金the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(No.ZYYCXTD-D-202408)the talented person scientific research starts funds subsidization project of Chengdu University of Traditional Chinese Medicine(No.030040043 and No.030040017)。
文摘The glucagon receptor(GCGR)is a critical target for the treatment of metabolic disorders such as Type 2 Diabetes Mellitus(T2DM)and obesity.Activation of GCGR enhances systemic insulin sensitivity through paracrine stimulation of insulin secretion,presenting a promising avenue for treatment.However,the discovery of effective GCGR agonists remains a challenging and resource-intensive process,often requiring time-consuming wet-lab experiments to synthesize and screen potential compounds.Recent advances in artificial intelligence technologies have demonstrated great potential in accelerating drug discovery by streamlining screening and efficiently predicting bioactivity.In the present work,we propose DeepGCGR,a two-layer deep learning model that leverages graph convolutional networks(GCN)integrated with a multiple attention mechanism to expedite the identification of GCGR agonists.In the first layer,the model predicts the bioactivity of various compounds against GCGR,efficiently filtering large chemical libraries to identify promising candidates.In the second layer,DeepGCGR classifies high bioactive compounds based on their functional effects on GCGR signaling,identifying those with potential agonistic or antagonistic effects.Moreover,DeepGCGR was specifically applied to identify novel GCGR-regulating compounds for the treatment of T2DM from natural products derived from traditional Chinese medicine(TCM).The proposed method will not only offer an effective strategy for discovering GCGR-targeting compounds with functional activation properties but also provide new insights into the development of T2DM therapeutics.
