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
Diabetic kidney disease (DKD)is one of the most common and severe microvascular complications of type 2 diabetes mellitus (T2DM). It is also a major cause of end-stage renal disease (ESRD), making early identification...Diabetic kidney disease (DKD)is one of the most common and severe microvascular complications of type 2 diabetes mellitus (T2DM). It is also a major cause of end-stage renal disease (ESRD), making early identification and intervention crucial. Insulin resistance (IR)is a key pathophysiological mechanism of T2DM and plays a central role in the progression of DKD. In recent years, a series of novel surrogate indicators of IR, such as the triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR), have attracted widespread attention due to their simplicity and cost-effectiveness. This article reviews the research progress of novel surrogate indicators of insulin resistance (IR) in type 2 diabetic kidney disease (DKD), aiming to provide references for the early prevention and improved prognosis of DKD.展开更多
Objective:To investigate the effects of switching to either Prandilin 25R monotherapy or Prandilin 25R combined with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion du...Objective:To investigate the effects of switching to either Prandilin 25R monotherapy or Prandilin 25R combined with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion during hospitalization in elderly patients with type 2 diabetes mellitus on glycemic control,glycometabolic indicators,and cardiovascular risk factors,and to evaluate the safety of the two regimens.Methods:A total of 78 elderly patients with type 2 diabetes mellitus admitted to our hospital from January 2025 to September 2025 were selected and randomly divided into a control group and an observation group,with 39 cases in each group.The control group received monotherapy with insulin lispro protamine recombinant injection(Prandilin 25R)after intensive continuous subcutaneous insulin infusion,while the observation group received Prandilin 25R combined with ganagliflozin proline tablets.Continuous glucose monitoring(CGM)was performed for 14 days during the intensive continuous subcutaneous insulin infusion therapy phase in the hospital,followed by routine fingertip blood glucose monitoring after 14 days.Glycemic control indicators,glycometabolic indicators,and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the mean amplitude of glycemic excursions and the 24-hour blood glucose standard deviation were significantly lower in the observation group than in the control group,while the time spent within the target blood glucose range was significantly higher(p<0.05).The levels of glycated hemoglobin,fasting blood glucose,and 2-hour postprandial blood glucose were better in the observation group than in the control group;moreover,the body mass index,systolic blood pressure,and blood lipid levels improved more significantly in the observation group than in the control group(p<0.05).There was no statistically significant difference in the incidence of hypoglycemia between the two groups.Conclusion:Combination therapy with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion therapy can effectively improve glycemic variability in elderly patients with type 2 diabetes mellitus,with good safety.This suggests that ganagliflozin proline tablets have a hypoglycemic advantage in the combination regimen and possess high clinical promotional value.展开更多
Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan b...Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan based on traditional Chinese medicine (TCM) for such patients. Methods: A randomized controlled study was conducted, selecting elderly patients with type 2 diabetic neurogenic bladder who met the inclusion criteria and randomly dividing them into a control group and an observation group. The control group received conventional comprehensive diabetes management and bladder function training, while the observation group additionally received auricular acupressure therapy, involving continuous stimulation of relevant auricular points such as Shenmen, Subcortex, Sympathetic, Kidney, Bladder, and Urethra, for a treatment duration of two courses. Changes in maximum urinary flow rate, bladder residual urine volume, TCM syndrome scores, and quality of life index (QOL) were compared between the two groups before and after treatment, and adverse reactions during treatment were recorded and analyzed. Results: After treatment, the observation group demonstrated superior improvement in clinical symptoms such as dysuria and urinary retention compared to the control group, with a significant increase in maximum urinary flow rate, a notable decrease in bladder residual urine volume and TCM syndrome scores, and a concurrent improvement in quality-of-life scores. The differences between the groups were statistically significant (p < 0.05). No serious adverse events occurred during treatment, and minor local discomfort resolved spontaneously after management, indicating overall good safety. Conclusion: As a simple and persistent TCM external treatment method, auricular acupressure therapy can further improve urinary function and quality of life in elderly patients with type 2 diabetic neurogenic bladder when combined with conventional treatment, with high safety and certain clinical promotion value.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 investigate the effects and potential mechanisms of action of Panax notoginseng(Burk)F.H.Chen(P.notoginseng,San Qi)flowers in type 2 diabetes mellitus(T2DM)using network pharmacology,in vivo experiments,a...Objective:To investigate the effects and potential mechanisms of action of Panax notoginseng(Burk)F.H.Chen(P.notoginseng,San Qi)flowers in type 2 diabetes mellitus(T2DM)using network pharmacology,in vivo experiments,and RNA sequencing(RNA-seq).Methods:Network pharmacology analysis was performed to identify and correlate the drug targets of flower buds of P.notoginseng(PNF)with T2DM disease targets and to predict the key targets and pathways involved in the therapeutic effects of PNF in T2DM.In vivo experiments were conducted to assess the effects of PNF on glucose and lipid metabolism in mice with T2DM.RNA-seq was performed,and the results were integrated with network pharmacology data to assess the therapeutic mechanisms of PNF in T2DM.The results from transcriptomics and network pharmacology were validated using real-time polymerase chain reaction.Results:A total of 27 intersecting targets were identified by overlapping 35 drug targets with T2DM targets.Further topological analysis using the Centiscape 2.2 tool revealed five core targets,including signal transducer and activator of transcription 3(STAT3).Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis indicated that the JAK/STAT signaling pathway is a key mechanism underlying the therapeutic effects of PNF in T2DM.In vivo experiments confirmed that PNF effectively regulates glycolipid metabolism in a mouse model of diabetes.KEGG pathway enrichment analysis of RNA-seq data highlighted the JAK2/STAT3 and PI3K/AKT pathway as a potential mechanism.PNF high-dose(PNFH)increased the gene expression levels of PIK3R1 and AKT2,decreased the expression of PCK1,JAK2,and STAT3,and showed a trend toward increasing INSR expression without reaching statistical significance.Conclusion:PNF improves glycolipid metabolism disorders in T2DM,potentially by modulating the JAK2/STAT3 and PI3K/AKT signaling pathway.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 Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are independent risk factors for the development of cardiovascular disease(CVD)and an exaggerated CVD risk is exp...BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are independent risk factors for the development of cardiovascular disease(CVD)and an exaggerated CVD risk is expected when both diseases co-exist.Therefore,thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.AIM To identify the CVD and cardiovascular event(CVE)risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.METHODS A systematic review was performed by compiling data by searching PubMed,EMBASE and Cochrane Library databases.Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute(JBI)tool and RevMan 5.4 software respectively.The effect indicators for CVE and CVD risk were expressed as odds ratios(OR)and 95%CI with P-values<0.05 as significant.RESULTS Fourteen(5 cohort and 9 cross-sectional)studies with 370013 participants were included in this review.The metaanalysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group[OR 1.28(95%CI,1.04-1.56)P=0.02]with follow up duration ranging between 5-6 years.The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher[OR 1.47(95%CI,1.21-1.78)P=0.0001]in T2DM with MAFLD when compared to T2DM without MAFLD.Significant heterogeneity exists due to variations in study design,methodologies,and MAFLD diagnostic criteria,which may have influenced the study's findings.CONCLUSION The presence of MAFLD in T2DM increased the risk of CVE.The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD.Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.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
BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To inves...BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.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 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
Parkinson's disease(PD),a chronic and com-mon neurodegenerative disease,is characterized by the progressive loss of dopaminergic neurons in the dense part of the substantia nigra and abnormal aggregation of alpha-...Parkinson's disease(PD),a chronic and com-mon neurodegenerative disease,is characterized by the progressive loss of dopaminergic neurons in the dense part of the substantia nigra and abnormal aggregation of alpha-synuclein.Type 2 diabetes mellitus(T2DM)is a metabolic disease characterized by chronic insulin resistance and deficiency in insulin secretion.Extensive evidence has con-firmed shared pathogenic mechanisms underlying PD and T2DM,such as oxidative stress caused by insulin resistance,mitochondrial dysfunction,inflammation,and disorders of energy metabolism.Conventional drugs for treating T2DM,such as metformin and glucagon-like peptide-1 receptor ago-nists,affect nerve repair.Even drugs for treating PD,such as levodopa,can affect insulin secretion.This review sum-marizes the relationship between PD and T2DM and related therapeutic drugs from the perspective of insulin signaling pathways in the brain.展开更多
In the unrelenting race to strive to dominate type 2 diabetes mellitus(T2DM)care better,this review paper sets out on a significant discovery trip across recent advancements in treatment and the blooming era of artifi...In the unrelenting race to strive to dominate type 2 diabetes mellitus(T2DM)care better,this review paper sets out on a significant discovery trip across recent advancements in treatment and the blooming era of artificial intelligence(AI)utilities.Given the considerable global burden of T2DM,innovative therapeutic approaches to improve patient outcomes remain a public health priority.This review first provides an in-depth analysis of the current state of therapy,from novel pharmacotherapy to lifestyle interventions and new treatment methods.At the same time,the rapidly increasing role of AI in diabetes care is woven into the story,mainly targeting how insulin therapy can be modified and personalized through algorithms and predictive modelling.It leaves a deep review of their pre-existing synergies,which helps understand how collaborative opportunities will unlock the future of T2DM care.This critical role is shown by integrating recent therapeutic advances and AI with overall showcasing better screening,diagnosis,and therapeutics decision-making to outcome prediction in T2DM.The review emphasizes how AI applications in insulin therapy have transformative potential in diabetes care.These person-centred approaches to T2DM management,which are more effective and personalized than some traditional strategies,only work because of the often-hidden synergies between AI algorithms in areas such as diagnostic criteria,predictive methods,and familiar classification tools for subgroups with relevant aspects/predictors on prognosis or treatment responsiveness.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
Background:Type 2 diabetes(T2D)accounts for the majority of diabetes incidences and remains a widespread global chronic disorder.Apart from early lifestyle changes,intervention options for T2D are mainly pharmaceutica...Background:Type 2 diabetes(T2D)accounts for the majority of diabetes incidences and remains a widespread global chronic disorder.Apart from early lifestyle changes,intervention options for T2D are mainly pharmaceutical.Methods:Repetitive transcranial magnetic stimulation(rTMS)has been approved by the FDA as a therapeutic intervention option for major depressive disorders,with further studies also indicating its role in energy metabolism and appetite.Considering its safe and non-invasive properties,we evaluated the effects of rTMS on systemic metabolism using T2D rats.Results:We observed that rTMS improved glucose tolerance and insulin sensitivity in T2D rats after a 10-day exposure.Improved systemic insulin sensitivity was main-tained after a 21-day treatment period,accompanied by modest yet significant weight loss.Circulating serum lipid levels,including those of cholesteryl ester,tryglyceride and ceramides,were also reduced following rTMS application.RNA-seq analyses fur-ther revealed a changed expression profile of hepatic genes that are related to sterol production and fatty acid metabolism.Altered expression of hypothalamic genes that are related to appetite regulation,neural activity and ether lipid metabolism were also implicated.Conclusion:In summary,our data report a positive impact of rTMS on systemic insu-lin sensitivity and weight management of T2D rats.The underlying mechanisms via which rTMS regulates systemic metabolic parameters partially involve lipid utilization in the periphery as well as central regulation of energy intake and lipid metabolism.展开更多
Type 2 diabetes mellitus(T2DM)promotes a risk of the development of atherosclerosis and potentiates atherosclerotic cardiovascular events.Among these patients,chronic hyperglycemia,dyslipidemia,oxidative stress and sy...Type 2 diabetes mellitus(T2DM)promotes a risk of the development of atherosclerosis and potentiates atherosclerotic cardiovascular events.Among these patients,chronic hyperglycemia,dyslipidemia,oxidative stress and systemic inflammation has been found as triggers for accelerating plaque formation.Additionally,conventionally used risk factors,such as age,overweight/obesity,hypertension,poor glycemic control,renal dysfunction,and metabolic disturbances frequently underestimate the patients at the risk of asymptomatic carotid atherosclerosis.Further interventions may be required to prevent vascular complications.To note,asymptomatic carotid plaque in T2DM is associated with older age,increased body mass index,biomarkers of poor glycemic control(glycated hemoglobin,fasting glucose),kidney dysfunction[urinary albumin-to-creatinine ratio(UACR)],and metabolic abnormalities[high-density lipoprotein cholesterol,serum uric acid(SUA)].However,renal(UACR)and metabolic(SUA)biomarkers are likely to be investigated as promising biomarkers for early stage of asymptomatic coronary atherosclerosis,which as expecting could improve diagnostic value of intima-media thickness.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
This article discusses the study by GrubićRotkvićet al on the mechanisms of action of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in patients with type 2 diabetes mellitus(T2DM)and heart failure(HF).T2DM and HF a...This article discusses the study by GrubićRotkvićet al on the mechanisms of action of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in patients with type 2 diabetes mellitus(T2DM)and heart failure(HF).T2DM and HF are highly comorbid,with a significantly increased prevalence of HF in patients with T2DM.SGLT2i exhibit potential in reducing hospitalization rates for HF and cardiovascular mortality through multiple mechanisms,including improving blood glucose control,promoting urinary sodium excretion,reducing sympathetic nervous system activity,lowering both preload and afterload on the heart,alleviating inflammation and oxidative stress,enhancing endothelial function,improving myocardial energy metabolism,and stabilizing cardiac ion homeostasis.Further research and clinical practice will help optimize the use of SGLT2i in HF patients.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
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Diabetic kidney disease (DKD)is one of the most common and severe microvascular complications of type 2 diabetes mellitus (T2DM). It is also a major cause of end-stage renal disease (ESRD), making early identification and intervention crucial. Insulin resistance (IR)is a key pathophysiological mechanism of T2DM and plays a central role in the progression of DKD. In recent years, a series of novel surrogate indicators of IR, such as the triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR), have attracted widespread attention due to their simplicity and cost-effectiveness. This article reviews the research progress of novel surrogate indicators of insulin resistance (IR) in type 2 diabetic kidney disease (DKD), aiming to provide references for the early prevention and improved prognosis of DKD.
文摘Objective:To investigate the effects of switching to either Prandilin 25R monotherapy or Prandilin 25R combined with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion during hospitalization in elderly patients with type 2 diabetes mellitus on glycemic control,glycometabolic indicators,and cardiovascular risk factors,and to evaluate the safety of the two regimens.Methods:A total of 78 elderly patients with type 2 diabetes mellitus admitted to our hospital from January 2025 to September 2025 were selected and randomly divided into a control group and an observation group,with 39 cases in each group.The control group received monotherapy with insulin lispro protamine recombinant injection(Prandilin 25R)after intensive continuous subcutaneous insulin infusion,while the observation group received Prandilin 25R combined with ganagliflozin proline tablets.Continuous glucose monitoring(CGM)was performed for 14 days during the intensive continuous subcutaneous insulin infusion therapy phase in the hospital,followed by routine fingertip blood glucose monitoring after 14 days.Glycemic control indicators,glycometabolic indicators,and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the mean amplitude of glycemic excursions and the 24-hour blood glucose standard deviation were significantly lower in the observation group than in the control group,while the time spent within the target blood glucose range was significantly higher(p<0.05).The levels of glycated hemoglobin,fasting blood glucose,and 2-hour postprandial blood glucose were better in the observation group than in the control group;moreover,the body mass index,systolic blood pressure,and blood lipid levels improved more significantly in the observation group than in the control group(p<0.05).There was no statistically significant difference in the incidence of hypoglycemia between the two groups.Conclusion:Combination therapy with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion therapy can effectively improve glycemic variability in elderly patients with type 2 diabetes mellitus,with good safety.This suggests that ganagliflozin proline tablets have a hypoglycemic advantage in the combination regimen and possess high clinical promotional value.
基金Clinical Study on the Treatment of Neurogenic Bladder in Elderly Patients with Type 2 Diabetes Mellitus by Auricular Point Pressing Needle TherapyZhejiang Provincial Traditional Chinese Medicine Science and Technology Project,Zhejiang Provincial People’s Hospital(Project No.:2024ZL252)。
文摘Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan based on traditional Chinese medicine (TCM) for such patients. Methods: A randomized controlled study was conducted, selecting elderly patients with type 2 diabetic neurogenic bladder who met the inclusion criteria and randomly dividing them into a control group and an observation group. The control group received conventional comprehensive diabetes management and bladder function training, while the observation group additionally received auricular acupressure therapy, involving continuous stimulation of relevant auricular points such as Shenmen, Subcortex, Sympathetic, Kidney, Bladder, and Urethra, for a treatment duration of two courses. Changes in maximum urinary flow rate, bladder residual urine volume, TCM syndrome scores, and quality of life index (QOL) were compared between the two groups before and after treatment, and adverse reactions during treatment were recorded and analyzed. Results: After treatment, the observation group demonstrated superior improvement in clinical symptoms such as dysuria and urinary retention compared to the control group, with a significant increase in maximum urinary flow rate, a notable decrease in bladder residual urine volume and TCM syndrome scores, and a concurrent improvement in quality-of-life scores. The differences between the groups were statistically significant (p < 0.05). No serious adverse events occurred during treatment, and minor local discomfort resolved spontaneously after management, indicating overall good safety. Conclusion: As a simple and persistent TCM external treatment method, auricular acupressure therapy can further improve urinary function and quality of life in elderly patients with type 2 diabetic neurogenic bladder when combined with conventional treatment, with high safety and certain clinical promotion value.
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 Creation and Talent Introduction Base of Prevention and Treatment of Diabetes and Its Complications withTraditional Chinese Medicine(B20055).
文摘Objective:To investigate the effects and potential mechanisms of action of Panax notoginseng(Burk)F.H.Chen(P.notoginseng,San Qi)flowers in type 2 diabetes mellitus(T2DM)using network pharmacology,in vivo experiments,and RNA sequencing(RNA-seq).Methods:Network pharmacology analysis was performed to identify and correlate the drug targets of flower buds of P.notoginseng(PNF)with T2DM disease targets and to predict the key targets and pathways involved in the therapeutic effects of PNF in T2DM.In vivo experiments were conducted to assess the effects of PNF on glucose and lipid metabolism in mice with T2DM.RNA-seq was performed,and the results were integrated with network pharmacology data to assess the therapeutic mechanisms of PNF in T2DM.The results from transcriptomics and network pharmacology were validated using real-time polymerase chain reaction.Results:A total of 27 intersecting targets were identified by overlapping 35 drug targets with T2DM targets.Further topological analysis using the Centiscape 2.2 tool revealed five core targets,including signal transducer and activator of transcription 3(STAT3).Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis indicated that the JAK/STAT signaling pathway is a key mechanism underlying the therapeutic effects of PNF in T2DM.In vivo experiments confirmed that PNF effectively regulates glycolipid metabolism in a mouse model of diabetes.KEGG pathway enrichment analysis of RNA-seq data highlighted the JAK2/STAT3 and PI3K/AKT pathway as a potential mechanism.PNF high-dose(PNFH)increased the gene expression levels of PIK3R1 and AKT2,decreased the expression of PCK1,JAK2,and STAT3,and showed a trend toward increasing INSR expression without reaching statistical significance.Conclusion:PNF improves glycolipid metabolism disorders in T2DM,potentially by modulating the JAK2/STAT3 and PI3K/AKT signaling pathway.
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 Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are independent risk factors for the development of cardiovascular disease(CVD)and an exaggerated CVD risk is expected when both diseases co-exist.Therefore,thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.AIM To identify the CVD and cardiovascular event(CVE)risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.METHODS A systematic review was performed by compiling data by searching PubMed,EMBASE and Cochrane Library databases.Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute(JBI)tool and RevMan 5.4 software respectively.The effect indicators for CVE and CVD risk were expressed as odds ratios(OR)and 95%CI with P-values<0.05 as significant.RESULTS Fourteen(5 cohort and 9 cross-sectional)studies with 370013 participants were included in this review.The metaanalysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group[OR 1.28(95%CI,1.04-1.56)P=0.02]with follow up duration ranging between 5-6 years.The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher[OR 1.47(95%CI,1.21-1.78)P=0.0001]in T2DM with MAFLD when compared to T2DM without MAFLD.Significant heterogeneity exists due to variations in study design,methodologies,and MAFLD diagnostic criteria,which may have influenced the study's findings.CONCLUSION The presence of MAFLD in T2DM increased the risk of CVE.The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD.Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.
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BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.
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 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supported by the National Natural Science Foundation of China(32161143021)the Iran National Science Foundation(4001873)+1 种基金the Henan Province Natural Science Foundation of China(182300410313)Henan University graduate Talent Program of Henan Province(SYLYC2023092).
文摘Parkinson's disease(PD),a chronic and com-mon neurodegenerative disease,is characterized by the progressive loss of dopaminergic neurons in the dense part of the substantia nigra and abnormal aggregation of alpha-synuclein.Type 2 diabetes mellitus(T2DM)is a metabolic disease characterized by chronic insulin resistance and deficiency in insulin secretion.Extensive evidence has con-firmed shared pathogenic mechanisms underlying PD and T2DM,such as oxidative stress caused by insulin resistance,mitochondrial dysfunction,inflammation,and disorders of energy metabolism.Conventional drugs for treating T2DM,such as metformin and glucagon-like peptide-1 receptor ago-nists,affect nerve repair.Even drugs for treating PD,such as levodopa,can affect insulin secretion.This review sum-marizes the relationship between PD and T2DM and related therapeutic drugs from the perspective of insulin signaling pathways in the brain.
文摘In the unrelenting race to strive to dominate type 2 diabetes mellitus(T2DM)care better,this review paper sets out on a significant discovery trip across recent advancements in treatment and the blooming era of artificial intelligence(AI)utilities.Given the considerable global burden of T2DM,innovative therapeutic approaches to improve patient outcomes remain a public health priority.This review first provides an in-depth analysis of the current state of therapy,from novel pharmacotherapy to lifestyle interventions and new treatment methods.At the same time,the rapidly increasing role of AI in diabetes care is woven into the story,mainly targeting how insulin therapy can be modified and personalized through algorithms and predictive modelling.It leaves a deep review of their pre-existing synergies,which helps understand how collaborative opportunities will unlock the future of T2DM care.This critical role is shown by integrating recent therapeutic advances and AI with overall showcasing better screening,diagnosis,and therapeutics decision-making to outcome prediction in T2DM.The review emphasizes how AI applications in insulin therapy have transformative potential in diabetes care.These person-centred approaches to T2DM management,which are more effective and personalized than some traditional strategies,only work because of the often-hidden synergies between AI algorithms in areas such as diagnostic criteria,predictive methods,and familiar classification tools for subgroups with relevant aspects/predictors on prognosis or treatment responsiveness.
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National Key Technologies Research and Development Program of China,Grant/Award Number:2020YFA0803701National Natural Science Foundation of China,Grant/Award Number:52107241,81973699 and 82274361CAMS Innovation Fund for Medical Sciences,Grant/Award Number:2021-12M-1-052。
文摘Background:Type 2 diabetes(T2D)accounts for the majority of diabetes incidences and remains a widespread global chronic disorder.Apart from early lifestyle changes,intervention options for T2D are mainly pharmaceutical.Methods:Repetitive transcranial magnetic stimulation(rTMS)has been approved by the FDA as a therapeutic intervention option for major depressive disorders,with further studies also indicating its role in energy metabolism and appetite.Considering its safe and non-invasive properties,we evaluated the effects of rTMS on systemic metabolism using T2D rats.Results:We observed that rTMS improved glucose tolerance and insulin sensitivity in T2D rats after a 10-day exposure.Improved systemic insulin sensitivity was main-tained after a 21-day treatment period,accompanied by modest yet significant weight loss.Circulating serum lipid levels,including those of cholesteryl ester,tryglyceride and ceramides,were also reduced following rTMS application.RNA-seq analyses fur-ther revealed a changed expression profile of hepatic genes that are related to sterol production and fatty acid metabolism.Altered expression of hypothalamic genes that are related to appetite regulation,neural activity and ether lipid metabolism were also implicated.Conclusion:In summary,our data report a positive impact of rTMS on systemic insu-lin sensitivity and weight management of T2D rats.The underlying mechanisms via which rTMS regulates systemic metabolic parameters partially involve lipid utilization in the periphery as well as central regulation of energy intake and lipid metabolism.
文摘Type 2 diabetes mellitus(T2DM)promotes a risk of the development of atherosclerosis and potentiates atherosclerotic cardiovascular events.Among these patients,chronic hyperglycemia,dyslipidemia,oxidative stress and systemic inflammation has been found as triggers for accelerating plaque formation.Additionally,conventionally used risk factors,such as age,overweight/obesity,hypertension,poor glycemic control,renal dysfunction,and metabolic disturbances frequently underestimate the patients at the risk of asymptomatic carotid atherosclerosis.Further interventions may be required to prevent vascular complications.To note,asymptomatic carotid plaque in T2DM is associated with older age,increased body mass index,biomarkers of poor glycemic control(glycated hemoglobin,fasting glucose),kidney dysfunction[urinary albumin-to-creatinine ratio(UACR)],and metabolic abnormalities[high-density lipoprotein cholesterol,serum uric acid(SUA)].However,renal(UACR)and metabolic(SUA)biomarkers are likely to be investigated as promising biomarkers for early stage of asymptomatic coronary atherosclerosis,which as expecting could improve diagnostic value of intima-media thickness.
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.
文摘This article discusses the study by GrubićRotkvićet al on the mechanisms of action of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in patients with type 2 diabetes mellitus(T2DM)and heart failure(HF).T2DM and HF are highly comorbid,with a significantly increased prevalence of HF in patients with T2DM.SGLT2i exhibit potential in reducing hospitalization rates for HF and cardiovascular mortality through multiple mechanisms,including improving blood glucose control,promoting urinary sodium excretion,reducing sympathetic nervous system activity,lowering both preload and afterload on the heart,alleviating inflammation and oxidative stress,enhancing endothelial function,improving myocardial energy metabolism,and stabilizing cardiac ion homeostasis.Further research and clinical practice will help optimize the use of SGLT2i in HF patients.
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.
