Current diabetes reviews最新文献

Background: Periodontitis is a prevalent inflammatory disease and a critical complication in individuals with Diabetes Mellitus (DM). The bidirectional relationship between periodontitis and DM exacerbates systemic inflammation and complicates disease management. Ozone therapy (OT), with its antimicrobial and immunomodulatory properties, has emerged as a promising adjunctive treatment for periodontitis in individuals with DM, though it remains underexplored. This scoping review evaluates the effects of OT on biomarkers associated with DM, which may indirectly suggest its potential as a complementary therapy for periodontitis management in DM.

Methods: A comprehensive search of PubMed, Cochrane, Embase, LIVIVO, Scopus, Web of Science, and LILACS (up to March 2024) identified 38 studies: 19 involving individuals with DM and 19 using DM animal models.

Results: OT positively influenced biomarkers such as Malondialdehyde (MDA), Superoxide Dismutase (SOD), reduced Glutathione (GSH), Catalase (CAT), Total Antioxidant Status (TAS), and Total Oxidant Status (TOS). OT also modulated inflammatory markers (TNF-α, IL-1β, IL-6, IL-8, IL-10, and CRP) and regenerative biomarkers (bFGF, BMP-2, CD34, VEGF, PDGF) while improving glycated hemoglobin (HbA1c). This study represents the first review to explore the effects of OT on DM biomarkers and infer possible implications of these effects if used as an adjunct in the treatment of periodontitis associated with DM.

Conclusion: OT may complement conventional periodontal treatments in individuals with DM by modulating biomarkers linked to periodontal health. These insights may guide future clinical studies to validate OT's role in the treatment and establish standardized protocols for its application in periodontal management in DM.

Diabetes mellitus is a worldwide health challenge and imposes a considerable strain on healthcare systems. By 2035, it is anticipated that around 592 million adults will be impacted by diabetes as a result of causes like aging, rapid population expansion, urbanization, obesity, lifestyle modifications, and heightened intake of calorie-dense, fatty, and fast meals. Despite the availability of several pharmaceutical therapies, they often come with higher expenses and adverse side effects, making them inaccessible to a large portion of the population. Bioactive compounds, especially flavonoids, are emerging as potential alternatives for diabetes management. Flavonoids, a category of polyphenolic chemicals included in fruits, vegetables, and various plant- derived foods, provide numerous therapeutic advantages. In addition to their glucose-lowering benefits, they increase antioxidant defence, improve insulin efficacy, and diminish the risk of cardiovascular problems. The clinical application of flavonoids is hindered by issues like poor solubility, low bioavailability, and complicated metabolism. This review explores the integration of nanotechnology- based delivery technologies to address these limitations. Advanced nano-formulations, such as polymeric nanoparticles, liposomes, micelles, and solid lipid nanoparticles, improve the solubility, stability, and absorption of flavonoids while facilitating targeted delivery and prolonged therapeutic benefits. The review highlights the efficacy of flavonoid-based nano-formulations in efficiently managing diabetes mellitus and its related problems. Moreover, it highlights the need for ongoing research to enhance these formulations and explore the molecular pathways that underlie their antidiabetic efficacy. This approach demonstrates the significance of nanotechnology in transforming diabetes care and enhancing patient outcomes.

Background & objective: FTO gene rs9939609, an obesity susceptible gene, has strong with type 2 diabetes mellitus (T2DM). Studies have also established an association between the FTO gene rs9939609 and cardiovascular disease (CVD). This research investigated the association of this genetic variant with microvascular and macrovascular complications related to diabetes.

Materials and methods: We performed a cross-sectional analysis involving 140 participants with T2DM and 70 healthy control subjects. The DNA samples were analyzed for the FTO gene variant rs9939609 using ARMS-PCR. FTO gene association with diabetes-related microvascular and macrovascular complications was assessed through multivariate logistic regression, with unadjusted odds ratios (OR) and 95% confidence intervals. A p- value below 0.05 was considered statistically significant.

Results: The genotypic distribution of the FTO gene variant adhered to Hardy-Weinberg equilibrium in the study participants (p>0.05).The AA genotype exhibited a robust association with elevated BMI, HbA1C, SBP, DBP, TGs and decreased HDL-C levels relative to the AT and TT genotypes with p=0.002. FTO genotype frequency increased from AA to AT to TT in both macrovascular (CVD) and microvascular complications (retinopathy, nephropathy, and neuropathy). Moreover, risk allele(A) was also significantly contributed to CVD (p=0.001), retinopathy (p=0.004), nephropathy (p=0.001) and neuropathy (p=0.002). AA genotype of the FTO gene rs 9939609 showed the tendency to increase the risk of CVD (OR,1.21; 95% CI,1.07-1.70; p=0.04) and retinopathy (OR,1.18; 95%CI,1.02-1.87;; p=0.001) while no significant changes were recorded in diabetic nephropathy (OR,1.56; 95%CI,1.2-2.43; p=0.67) and neuropathy (OR,2.49; 95%,1.52-4.1; p=0.06).

Conclusion: Our data indicate that the FTO gene variant rs 9939609 is linked to an elevated risk of both microvascular & macrovascular complications in individuals with T2DM.

Wound healing is a complex, tightly regulated biological process essential for restoring the integrity and functionality of damaged skin. Chronic wounds, affecting approximately 6.5 million individuals globally and 1.5% of the Indian population, pose significant healthcare challenges due to their prolonged and intricate healing processes. This review highlights the mechanisms and stages of wound healing-hemostasis, inflammation, proliferation, and maturation-emphasizing the bidirectional influence of internal and external factors on wound progression. Despite advancements in wound management, current therapeutic options, including skin grafts, growth factors, and cell-based therapies, often remain inadequate for diverse wound types. Emerging technologies, such as nanofibers, stem cell therapy, 3D bioprinting, fluorescence imaging, and bacteria- killing laser therapy, offer promising solutions by enhancing therapeutic outcomes and minimizing side effects. This review also explores the roles of nutrition, physical therapy, and traditional medicine in promoting effective wound care. By integrating novel technologies with established therapeutic strategies, this work provides a comprehensive overview of advanced wound healing modalities, their mechanisms, advantages, and limitations. The review concludes with a perspective on future research directions aimed at overcoming current challenges in chronic wound management and optimizing patient outcomes.

Introduction: Medicago sativa (M. sativa), commonly known as Alfalfa, is a herb from the Fabaceae family that has a long history of being used to treat digestive, diabetic, and blood disorders, as well as to support liver health. The objective was to evaluate the effects of ethanolic extract of M. sativa (EEMS) on wounds in normal rats or alloxan hydrate-induced diabetic rats.

Method: The wounds were created by excision (n=30) and incision (n=30) in rats. The Group II-V were diabetic rats treated with simple ointment BP, 10% weight-based povidone-iodine (10% PI), ointment of 5% w/w EEMS (5% w/w OEEMS), and 10% w/w EEMS (10% w/w OEEMS). Group 1 acted as a control and was treated with simple ointment BP. The wound area in the diabetic control groups was 292.33±0.8 mm sq. on the 18th day.

Results: Rats treated with 10% PI, 5% OEEMS, and 10% OEEMS showed a significant reduction in wound area of 68.33±1.29, 248.33±1.30, and 61±1.91 mm sq., respectively, on the 18th day as compared to the control group. Rats treated with 10% PI, 5% w/w OEEMS, and 10% w/w OEEMS showed a significant increment in wound-breaking strength, respectively, as compared to diabetic rats on day 10 in the incision wound model.

Conclusion: The results demonstrated that the OEEMS has potent wound-healing properties in diabetic rats.

Diabetic-related complications, such as delayed and incomplete wound healing, are an increasing concern in the realm of public health. Ferroptosis represents an innovative variant of cellular demise. Ferroptosis is currently thought to be an essential factor in the process of diabetic wound recovery. This article, therefore, examines the novel function and mechanism of ferroptosis in the repair of diabetic wounds. Diabetic hyperglycemia can induce a healing process that disrupts the function and activity of cells, thereby impeding the repair of diabetic wounds. Ferroptosis may be accelerated in diabetic lesions due to protracted low-level inflammation and oxidative stress induced by elevated glucose, according to the available evidence. As a result, the buildup of ferroptosis impedes cellular migration and proliferation, amplifies oxidative stress and the inflammatory response, and ultimately interferes with the wound-healing process. By regulating the expression of factors linked to iron mortality, this substance expedites wound healing and fosters angiogenesis in diabetic rodents. Moreover, new perspectives on the difficulties and outlooks related to ferroptosis in the context of diabetic wound healing are provided, thereby contributing to the progression of understanding in this field.

Aims: This study aims to investigate the relationship between sarcopenia and circulating biomarkers in diabetes, with a focus on early detection and effective management strategies.

Methods: A literature review was conducted using the ScienceDirect, Scopus, PubMed, and Web of Science databases up to December 2024. Key search terms included "diabetes," "sarcopenia," "HbA1c", "glucose," "insulin," and specific biomarkers such as inflammatory markers, adipokines, and myokines.

Results: Aging is associated with a decline in organ and bodily system functionality, with sarcopenia being particularly prominent due to its progressive loss of muscle mass and function. This condition increases health risks and mortality in the elderly. Muscles, as the primary consumers of glucose, play a crucial role in glucose uptake; reduced mass can exacerbate insulin resistance. Sarcopenia and diabetes share common pathophysiological mechanisms, including insulin resistance, inflammation, and vascular complications. Circulating biomarkers, crucial for diabetes management, may offer insights into the early stages of sarcopenia.

Conclusion: The complex relationship between sarcopenia and diabetes, influenced by shared pathophysiological pathways, presents challenges in geriatric healthcare. Circulating biomarkers hold promise for early detection and monitoring of sarcopenia, potentially enhancing patient outcomes and quality of life. Further research is necessary to validate these connections and develop targeted treatments for individuals affected by these conditions.

The composition of the diet has altered over the past few decades, with a significant increase in the consumption of dietary sugars, particularly fructose, which has risen more than tenfold. This elevated consumption of fructose and sugars is considered to be one of the major risk aspects for the emergence of obesity and other metabolic disorders. In this review, we discuss the correlation between insulin resistance and NAFLD (nonalcoholic fatty liver disease) due to dietary fructose intake. Type 2 Diabetes Mellitus (T2DM) is spreading quickly over the world and has epidemic proportions. The risk of both hepatic and metabolic abnormalities is increased by their connection, founded on shared metabolic risk factors such as obesity, (IR) Insulin Resistance, and an unhealthy standard of living. This review highlights the prevalence of coexisting T2DM (Type 2 diabetes) and NAFLD (Non-Alcoholic Fatty Liver Disease) in the community. In summary, the key pathophysiological pathways and risk stratification algorithms for the onset of nonalcoholic fatty liver disease and type 2 diabetes have been covered.

The connection between COVID-19 and DM unveils a multifaceted interplay that significantly impacts disease severity and management strategies. Initial studies reveal that people with DM had higher severity rates of COVID-19 due to the infection by SARS-CoV-2. The virus solely induces hyperglycemia and, at the same time, profoundly influences the immune and inflammatory reactions, increasing the rate of severe complications and death among diabetes patients. Therefore, understanding the underlying mechanisms behind this interplay is critical for effective treatment. Furthermore, COVID-19 also brings new factors to the equation of managing diabetes. Although the virus thoroughly relies on the ACE2 receptor for viral entry, DPP4 is a substitute receptor. However, glucose-lowering DPP4 inhibitors provide only a minor association with COVID-19 vulnerability. Also, the SGLT2 inhibitors are contraindicated in certain conditions with COVID-19, and hence, insulin is generally recommended as a first-line treatment for acute glycemic control in hospitalized or critically ill COVID-19 patients, particularly those with severe hyperglycemia or diabetic ketoacidosis. COVID-19-associated aggravating factors, such as cardiovascular disease, chronic kidney disease, and neuropathy, predispose people with diabetes to severe conditions. Thus, it is important to explore this speculation, and the present review aims to understand this complex interaction during patient care models and specify the therapeutic approaches to address this problematic convergence of two substantial health concerns.