Current diabetes reviews最新文献

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Introduction: Type 2 diabetes (T2D) is a prevalent metabolic disorder linked to chronic inflammation and endothelial dysfunction, which contributes to the development of microvascular complications (MVCs) such as diabetic retinopathy (DR) and diabetic neuropathy (DN). Genetic factors, including variations in the ABO gene, may influence these complications. This study aimed to investigate the association between the ABO rs2073823 polymorphism and the risk of MVCs in patients with T2D, as well as its impact on inflammatory biomarkers, endothelial markers, and lipid profiles.

Materials and methods: We conducted an exploratory study involving 96 T2D Iraqi patients (Asian Arabic), examining the distribution of the ABO rs2073823 polymorphism and its correlation with MVCs. We assessed levels of inflammatory markers (TNF-α, IL-6, sE-selectin, sP-selectin), glycemic markers, renal function biomarkers, and lipid profiles. Adjustment was made for confounding factors including age, gender, body mass index, duration of diabetes, and hypertension.

Results: Among the participants, 75% had MVCs, including DR (42%) and DN (65%). The ABO rs2073823 "A/A" genotype was associated with a reduced risk of MVCs under co-dominant (OR=0.16, p=0.045) and recessive models (OR=0.14, p=0.031). This protective effect remained significant after adjusting for confounding factors (OR=0.11, p=0.022). The "A/A" genotype was also linked to lower levels of total cholesterol, LDL-cholesterol, triglycerides, and sP-selectin. Patients with MVCs exhibited significantly higher levels of TNF-α, IL-6, and sP-selectin.

Conclusion: The ABO rs2073823 polymorphism, particularly the "A/A" genotype, is associated with a decreased risk of MVCs in T2D patients and influences lipid metabolism and inflammatory markers. These findings suggest a genetic basis for the susceptibility to MVCs and highlight the role of the ABO gene in modulating inflammation and endothelial function in T2D. Further research is needed to validate these associations and explore potential therapeutic implications.

Objective: The aim of this study was to synthesize scientific evidence on the influence of health literacy and numerical knowledge on self-monitoring of capillary blood glucose.

Methods: Adhering to the PRISMA guidelines and the principles of the Joanna Briggs Institute, a comprehensive search was conducted across multiple databases, including CINAHL, Cochrane, Embase, LILACS, PubMed, Scopus, Web of Science, Google Scholar, OPENGREY, and NDLTD. The review included studies published in any language that examined the relationship between HL, numeracy, and SMBG.

Results: A total of 12 studies met the inclusion criteria. These studies utilized various assessment tools, such as the Brief Test of Functional Health Literacy in Adults (B-TOFHLA) and the Diabetes Numeracy Test (DNT-15), to evaluate health literacy and numeracy levels. The findings revealed a significant association between adequate HL and numeracy and improved SMBG practices. Specifically, individuals with sufficient health literacy were more likely to monitor their blood glucose levels regularly and make appropriate treatment adjustments based on their readings.

Conclusion: The results indicated that numeracy skills and health literacy are critical determinants of effective SMBG, influencing the frequency and accuracy of self-care practices in diabetes management. These findings highlight the urgent need for educational interventions tailored to enhance these skills, which could lead to improved health outcomes for individuals with diabetes.

Objectives: Owing to the existing evidence of the implication of oxidative stress in the pathophysiology of type 2 diabetes mellitus (T2DM), the present study aims to investigate the correlation of serum total antioxidant status (TAS) with comorbidities, various biochemical parameters, and duration of T2DM. Various factors contributing to disease prevalence and trends in other biochemical parameters are assessed.

Methods: A retrospective observational study of 246 patients with T2DM whose data were retrieved from the Proficiency Health Diagnostic Lab System in Al Ain. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) program.

Results: The prevalence of T2DM was found to be higher in gender (male), age (≥45 years), ethnicity (Middle Eastern), BMI (≥25), family history, and metabolic syndrome (hypertension and dyslipidemia). TAS was found to be significantly higher in patients with comorbidities, than in those without, particularly dyslipidemia and micro-albuminuria (p<0.05). TAS was weakly positively correlated with various T2DM biochemical parameters (p<0.05), except for Fasting blood glucose (FBG) (p=0.061). TAS was weakly negatively correlated with BMI (≥25) (p=0.042). Albumin- to-creatinine ratio (ACR) was statistically higher in hypertensives than normotensives (p=0.049). Duration of disease was only significantly correlated with ACR (r=0.325, p=0.001). Uric acid levels were statistically higher in patients with microalbuminuria than in patients without microalbuminuria (p=0.001).

Conclusion: TAS was higher in patients with dyslipidemia and microalbuminuria, suggesting the influence of other factors such as uric acid and lipid-lowering agents. TAS could be an important factor in the management of T2DM cases. This needs to be further investigated in future studies to fill the gap found in the literature.

Background: Type 1 diabetes (T1D) is an autoimmune disorder characterized by a complex interplay of genetic and environmental factors.

Aim: The objective of this study was to identify the risk factors associated with T1D in the southern region of Iran during the year 2022.

Methods: This research employed a case-control design involving two groups (79 individuals in each group) of healthy children and adolescents diagnosed with T1D. The study assessed and compared the groups regarding various potential risk factors that may influence the development of T1D. Data analysis was performed using SPSS-22 software.

Results: Significant differences were observed between the two groups concerning several factors, including the age at which children began kindergarten, their weight at one year and 18 months, maternal weight gain during pregnancy, delivery method, age of introduction to complementary feeding, duration of breastfeeding, use of cow's milk and vitamin D supplements before one year of age, as well as family history of T1D and other autoimmune diseases among fathers and siblings.

Conclusion: The findings indicate that, in addition to genetic predispositions, numerous environmental factors contribute to the risk of developing T1D. Consequently, it is recommended that health managers and policymakers investigate these risk factors more broadly across various regions to implement effective strategies aimed at reducing the incidence of T1D nationwide.

Background: Dating violence is a prevalent issue among Mexican women, as is the incidence and prevalence of Type 2 diabetes mellitus (T2DM). The effects of dating violence can negatively impact lifestyle and, consequently, increase the risk of T2DM.

Objective: This study aimed to explore the influence of dating violence on lifestyle and the risk of T2DM in women university students from Mexico.

Methods: The study employed a cross-sectional and correlational design. The study population consisted of women university students. The sample size included 255 participants. Women aged 18 to 39 with current dating relationships and residency in Mexicali, Baja California, Mexico, were included. Data collection was conducted from February to May 2023. Correlations and multiple linear regression models were conducted.

Results: A total of 255 women participated, with an average age of 21.6 years (SD = 3.2), and 32.2% had a history of intrafamily violence during childhood. 58.8% of the participants exhibited some level of risk of T2DM, and 56.7% of the lifestyle was mostly categorized as poor/fair. Detachment was the most prevalent type of dating violence, followed by coercion. Dating violence was correlated with lifestyle (r = -.430) and the risk of T2DM (r = .321). In the multiple linear regression model, dating violence influenced the risk of T2DM.

Conclusion: Women who reported higher levels of dating violence have a less healthy lifestyle and a greater risk of T2DM. It is important to consider dating violence to improve lifestyle and prevent T2DM in Mexican women university students.

The Central nervous system (CNS) is the prime regulator of signaling pathways whose function includes regulation of food intake (consumption), energy expenditure, and other metabolic responses like glycolysis, gluconeogenesis, fatty acid oxidation, and thermogenesis that have been implicated in chronic inflammatory disorders. Type 2 diabetes mellitus (T2DM) and obesity are two metabolic disorders that are linked together and have become an epidemic worldwide, thus raising significant public health concerns. Fibroblast growth factor 21 (FGF21) is an endocrine hormone with pleiotropic metabolic effects that increase insulin sensitivity and energy expenditure by elevating thermogenesis in brown or beige adipocytes, thus reducing body weight and sugar intake. In contrast, during starvation conditions, FGF21 induces its expression in the liver to initiate glucose homeostasis. Insulin resistance is one of the main anomalies caused by impaired FGF21 signaling, which also causes abnormal regulation of other signaling pathways. Tumor necrosis factor alpha (TNF-α), the cytokine released by adipocytes and inflammatory cells in response to chronic inflammation, is regarded major factor that reduces the expression of FGF21 and modulates underlying insulin resistance that causes imbalanced glucose homeostasis. This review aims to shed light on the mechanisms underlying the development of insulin resistance in obese individuals as well as the fundamental flaw in type 2 diabetes, which is malfunctioning obese adipose tissue.

The term "Diabetic neuropathy" refers to a collection of clinical and subclinical symptoms caused by problems with the peripheral nervous system. Diabetes, which affects approximately 381 million people worldwide, is the source of dysfunction due to the emergence of microvascular complications. It is anticipated that in the next ten years, Diabetic neuropathy will manifest in about 50% of patients who are currently diagnosed with diabetes. Clinical diagnosis can be established by getting a thorough patient history and exploring the symptoms to rule out alternative causes. Although distal symmetrical polyneuropathy, or just, is the most common and well-researched variant of the disorder, this review will concentrate on it. The multifactorial pathogenesis is linked to various inflammatory, vascular, metabolic, and neurodegenerative illnesses. The three fundamental molecular alterations that lead to the development of diabetic neuropathic pain are oxidative stress, endothelial dysfunction, and chronic inflammation. These three elements are crucial in the development of polyneuropathy because their combination might result in direct axonal damage and nerve ischemia. The purpose of this article was to provide a narrative review of diabetic neuropathy. We provide an overview of the most recent data on biomarkers, the pathogenesis of the illness, the most recent epidemiology of diabetic neuropathy, and the existing screening and diagnosis outcome measures used in both clinical and research contexts.

Objective: The aim of this study was to assess how the lockdown of the COVID-19 pandemic had affected the glycaemic control of adolescents aged 10-19 with type 1 diabetes.

Methods: A comprehensive search of literature was performed in PubMed, Scopus, Web of Science, and ProQuest. Published articles up to September 2022 were included. The Glucose Monitoring Index (GMI) and HbA1c level were defined as outcome variables. Average glucose level was found to be a common variable in both HbA1c levels and GMI; therefore, HbA1c and GMI were converted to average glucose (mg/dL) using appropriate formulas. Studies reported the outcomes in two or three periods (pre-lockdown, lockdown, and post-lockdown) were included in the analysis. A paired wise meta-analysis was performed among the studies that reported all three periods. Homogeneity across studies was assessed using I2 statistic.

Result: Fourteen studies were included in the study. The pooled average glucose during the lockdown decreased to 166.9 mg/dL (95% CI, 153.78, 180.02) from 205.793 mg/dL (95% CI, 188.412, 223.173) during the pre-lockdown period, then it increased to 204.23 mg/dL (95% CI, 186.17, 222.29) during the post-lockdown period. A paired wise meta-analysis indicated a reduction in average glucose levels. However, it was not statistically significant, possibly due to the small number of studies that reported data from all three periods.

Conclusion: Although the descriptive analysis of our study showed that the lockdown had affected (decreased) the average glucose level among adolescents with type 1 diabetes, this was not statistically significant in the pooled analysis.

Objective: This network meta-analysis [NMA] investigated the efficacy of adjunctive use of subgingivally delivered antimicrobials to non-surgical periodontal therapy [NSPT] in the glycemic control and periodontal pocket depth (PPD) reduction in patients with type 2 diabetes (T2D).

Methods: Seven databases, grey literature, and registry platforms were searched up to February 2024 to identify randomized clinical trials (RCT) fulfilling the eligibility criteria. The risk of bias was assessed through Cochrane's tool (RoB 2). Two frequentist NMA were performed using a random-effects model to calculate mean differences (MD) as an effect measure and to quantitatively evaluate the glycated hemoglobin (HbA1c) and PPD. The certainty of evidence was assessed through the GRADE approach in a partially contextualized framework for interpreting results. Ten RCTs were included.

Results: In total, 261 patients were treated with eight different local antimicrobials adjuvants to NSPT (azithromycin gel, clarithromycin gel, tetracycline fiber or ointment, chlorhexidine gel, doxycycline nanospheres, minocycline gel, and satranidazole gel), while 249 patients received NSPT alone or associated to placebo. Considering PPD reduction (8 included studies), the best results were found after six months for satranidazole gel (MD -2.64 mm; 95%CI -3.56, -1.72; moderate evidence certainty). For HbA1c control (7 included studies), doxycycline gel (MD - 0.80%; 95%CI -1.70, 0.10), chlorhexidine gel (MD -0.68%; 95%CI -1.34, -0.02), and tetracycline fiber (MD -0.62%; 95%CI -0.85, -0.39) showed promising results after three months (low evidence certainty).

Conclusion: The adjunctive use of satranidazole gel probably reduces PPD after a 6-month follow-up, while doxycycline gel, chlorhexidine gel, and tetracycline fiber may decrease HbA1c values in patients with T2D and periodontitis treated with NSPT after a 3-month follow up.