Current diabetes reviews最新文献

Background: There are numerous cross-sectional studies showing an association between arterial stiffness and diabetes, but the temporality of the association is unclear.

Objective: To investigate the temporal relationship between arterial stiffness and diabetes.

Methods: We searched MEDLINE and Embase from inception to 31 August 2023, to identify cohort studies that assessed whether arterial stiffness, as measured by pulse wave velocity (PWV), was predictive of the development of diabetes and vice versa. We summarised study data, and where possible undertook meta-analysis.

Results: We identified 19 studies that included people with type 1, type 2 and gestational diabetes. All 11 studies investigating arterial stiffness as a predictor of diabetes found a significant relationship. Six of those studies were suitable for meta-analysis. The risk of developing diabetes was greater in people with higher PWV at baseline than lower PWV (RR = 2.14, 95%CI 1.65 to 2.79, p < 0.00001) and the mean difference in baseline PWV was higher in people who developed diabetes than those who did not (mean difference: 0.77 m/s, 95%CI 0.47 to 1.06, p < 0.00001). Of 8 studies investigating diabetes as a predictor of arterial stiffness, 7 found a significant relationship.

Conclusion: There is evidence of a bidirectional relationship between arterial stiffness and diabetes. Arterial stiffness may provide a causal link between diabetes and future cardiovascular disease.

Background: The control of blood pressure (BP) is a challenge in diabetic patients and is associated with adverse outcomes of diabetes. In this systematic review and metaanalysis, we investigated the BP control rate among hypertensive diabetic patients in the Eastern Mediterranean Region (EMR) countries.

Methods: We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases up to January 2023 for observational studies on BP control among hypertensive diabetic patients in all EMR countries. We included studies reporting the proportion of hypertensive, type 2 diabetic patients with controlled BP, defined as systolic/diastolic BP < 140/90 or <130/80 mmHg. Study quality was assessed using modified STROBE guidelines, and a random- effect meta-analysis was conducted to pool prevalence data and calculate overall rates. Subgroup analysis was performed by gender, study design, country, and BP control cut-offs (140/90 and 130/80).

Results: Among the 1949 retrieved studies, 20 studies assessing 27956 individuals were included. The proportion of BP control regardless of cut-off points was 36.8% (95% CI=29.1%45.3%) based on the studies reported for both genders.The prevalence was 53.2% (95% CI=36.1%- 69.6%) and 43.5% (95% CI=20.0%-70.3%) based on the studies reported just for women or men, respectively.

Conclusion: Our findings indicate that BP control targets are not successfully achieved in hypertensive diabetic patients in the Eastern Mediterranean region. It is recommended to place greater emphasis on the quality of hypertension care in the management of type 2 diabetes.

Diabetes, regarded as a prevalent metabolic disorder with multifactorial origins, contributes to a myriad of global complications. These cumulate an elevated susceptibility to kidney failure, nerve impairment, blindness, atherosclerosis, heart ailments, and even strokes. Recent investigations underscore the diverse roles of associated biomarkers in diabetes progression. Among these are biomarkers for diabetes mellitus such as DPP-4, PPAR-ϒ, SGLT-2, α-amylase, and α-glucosidase, which are linked to the onset of diabetes and its related problems. As a result of undesirable adverse consequences linked to extant synthetic antidiabetic medications, research attention is increasingly directed towards formulating natural antidiabetic drugs, aiming for enhanced efficacy and reduced complications. Cyanobacteria stand out as a pivotal repository of natural bioactive metabolites extensively harnessed for pharmaceutical and nutraceutical development. The potent bioactive compounds sourced from cyanobacteria hold substantial promise, kindling high expectations in scientific research and presenting vast prospects for drug discovery and advancement. Some of these bioactive compounds have demonstrated impressive effectiveness, displaying successful applications across various phases of clinical trials. This review strives to provide a more precise understanding of diabetes mellitus, encompassing its clinical manifestation, epidemiological data, complications, and prevailing treatment modalities. The objective of this review is to contribute researchers and readers an enhanced and accurate understanding of diabetes mellitus by covering its clinical manifestation, epidemiological evidence, difficulties, and prevailing therapeutics possibilities.

Background: Prevention and reduction of liver fat accumulation and maintenance of Glomerular Filtration Rate (GFR) have been proposed as important therapeutic goals in patients with Type 2 Diabetes Mellitus (T2DM).

Aim: This study aimed to determine the effect of Low-Volume High-Intensity Interval Training (LV-HIIT) on fatty liver index (FLI) and GFR estimation in patients with T2DM.

Methods: This randomized controlled trial included 80 patients with T2DM and a sedentary lifestyle, randomly divided into HIIT (n=40) and a control group (n=40). Patients with a history of T2DM for at least one year and HbA1C levels between 6.4% and 10% were selected. The intervention group underwent a 4-week LV-HIIT course, comprising 3 sessions per week, while the control group did not receive any intervention. FLI, eGFR, anthropometric measurements, and laboratory variables were assessed in all participants before and after the intervention.

Results: FLI (62.0 at baseline, 53.0 at follow-up) significantly decreased in the LV-HIIT group after the intervention, while eGFR (71.0 at baseline, 73.6 at follow-up) significantly increased (P<0.001). However, the control group showed a significant reduction only in Fasting Blood Sugar (FBS) (P<0.05). After the intervention, the LV-HIIT group had significantly lower FBS (129.0 at baseline, 121.0 at follow-up), Alanine Aminotransferase (ALT) (24.0 at baseline, 18.0 at follow-up), and Gamma-Glutamyl Transferase (GGT) (22.0 at baseline, 19.0 at follow-up), as well as higher eGFR, compared to the control group (P<0.05).

Conclusions: LV-HIIT exercise appears to be a promising and effective training method for improving FLI and eGFR in patients diagnosed with T2DM.

Clinical trial registration: IRCT 20200 729048246N1.

Diabetic neuropathy, also known as diabetic peripheral sensorimotor neuropathy (DPN), is a consequential complexity of diabetes, alongside diabetic nephropathy, diabetic cardiomyopathy, and diabetic retinopathy. It is characterized by signs and symptoms of peripheral nerve damage in diabetes patients after ruling out other causes. Approximately 20% of people with diabetes are affected by this painful and severe condition. The development of diabetic neuropathy is influenced by factors such as impaired blood flow to the peripheral nerves and metabolic issues, including increased polyol pathway activation, myo-inositol loss, and nonenzymatic glycation. The present review article provides a brief overview of the pathological changes in diabetic neuropathy and the mechanisms and types of DPN. Various diagnostic tests and biomarkers are available to assess nerve damage and its severity. Pharmacotherapy for neuropathic pain in diabetic neuropathy is complex. This review will explore current treatment options and potential future developments to improve the quality of life for patients suffering from diabetic neuropathy.

Background: Diabetes Mellitus (DM) is an alarming health concern, affecting approximately 537 million people worldwide. As a leading cause of morbidity and mortality, DM demands a comprehensive understanding of its diverse pathophysiological mechanisms and disease progression.

Methods: This traditional review has consolidated literature on the pathogenesis of hyperglycemia, its progression into complications, and advances in optimal treatment strategies. The literature in the last two decades has been reviewed using several keywords, including "diabetes," "diabetes-associated complications", "novel therapeutic interventions for diabetes-associated diseases", "phyto-extracts as antidiabetic drugs", etc. in prominent databases, such as PubMed, Scopus, Google Scholar, Web of Science, and ClinicalTrials.gov.

Results: We have discussed macrovascular and microvascular complications, such as atherosclerosis, cardiovascular disease, Peripheral Arterial Disease (PAD), stroke, diabetic nephropathy, retinopathy, and neuropathy, as well as various pharmacological and non-pharmacological interventions that are currently available for the management of DM. We have also focused on the potential of natural products in targeting molecular mechanisms involved in carbohydrate metabolism, insulin production, repair of pancreatic cells, and reduction of oxidative stress, thereby contributing to their antidiabetic activity. Additionally, novel therapeutic approaches, like genetic, stem cell, and immunomodulatory therapies, have been explored. We have also discussed the benefits and limitations of each intervention, emerging research and technologies, and precision medicine interventions.

Conclusion: This review has emphasized the need for an improved understanding of these advancements, which is essential to enhance clinicians' ability to identify the most effective therapeutic interventions.

Aims: The objective of this study was to investigate the correlation between serum 25 hydroxyvitamin D [25(OH)D] levels and insulin resistance, as well as metabolic associated fatty liver disease (MAFLD) in newly diagnosed with type 2 diabetes mellitus (T2DM) patients.

Method: A retrospective analysis was conducted on 491 T2DM patients who were newly diagnosed between January 2017 and August 2022 at Peking University International Hospital. These patients were categorized into three groups based on their 25(OH)D levels.

Results: The prevalence of MAFLD was significantly elevated in both the Vitamin D (VD) deficiency group and the VD insufficiency group compared to the VD sufficiency group (χ2 = 6.51, p<0.05). The patients in the VD sufficiency group had lower levels of insulin resistance, as assessed by the homeostasis model assessment when compared to the VD deficiency group and the VD insufficiency group (F = 8.61, p<0.05). Additionally, the VD sufficiency group demonstrated higher levels of β cell function in comparison to the other two groups (p<0.05, respectively). A significant negative correlation was observed between 25(OH)D levels and insulin resistance, as assessed by the homeostasis model assessment in T2DM patients(r=-0.33, p<0.05 for females; r=-0.32, p<0.05 for males). In male patients, 25(OH)D was identified as a protective factor against MAFLD(OR = 0.42;95%CI:0.19-0.95;p <0.05). Meanwhile, in female patients, 25(OH)D was also associated with a reduced risk of MAFLD(OR = 0.35;95%CI 0.17-0.89; p<0.05). Additionally, the study determined that the threshold values for 25(OH)D were 15.06 ng/ml in female patients and 18.79 ng/ml in male patients for predicting MAFLD.

Conclusion: In newly diagnosed with T2DM patients, the level of 25(OH)D may be related to insulin resistance and β cell secretion function independently and VD deficiency is an independent risk factor for MAFLD in patients with newly diagnosed T2DM.

Background: Diabetes mellitus (DM), arising from pancreatic β-cell dysfunction and disrupted alpha-amylase secretion, manifests as hyperglycemia. Synthetic inhibitors of alphaamylase like acarbose manage glucose but pose adverse effects, prompting interest in plantderived alternatives rich in antioxidants and anti-inflammatory properties.

Objective: The current review investigates plant-based alpha-amylase inhibitors, exploring their potential therapeutic roles in managing DM. Focusing on their ability to modulate postprandial hyperglycemia by regulating alpha-amylase secretion, it assesses their efficacy, health benefits, and implications for diabetes treatment.

Methods: This review examines plant-derived alpha-amylase inhibitors as prospective diabetic mellitus treatments using PubMed, Google Scholar, and Scopus data.

Results: Plant-derived inhibitors, including A. deliciosa, B. egyptiaca, and N. nucifera, exhibit anti-inflammatory and antioxidant properties, effectively reducing alpha-amylase levels in diabetic conditions. Such alpha-amylase inhibitors showed promising alternative treatment in managing diabetes with reduced adverse effects.

Conclusion: The current literature concludes that plant-derived alpha-amylase inhibitors present viable therapeutic avenues for diabetes management by modulating alpha-amylase secretion by regulating inflammatory, oxidative stress, and apoptotic mechanisms involved in the pathogenesis of diabetes. Further investigation into their formulations and clinical efficacy may reveal their more comprehensive diabetes therapeutic significance, emphasizing their potential impact on glucose regulation and overall health.

Background/introduction: Albuminuria in Diabetes mellitus (DM) patients may lead to nephropathy and end-stage renal disease. Our study aimed to assess the prevalence of albuminuria and its associated predictors among type 2 DM patients in the United Arab Emirates.

Methods: A retrospective cross-sectional study was conducted among type 2 DM patients in the diabetic clinic at Fujairah Hospital from 1st January 2016 to 30th January 2020 after getting the ethical clearance. Data were collected electronically from the health information system and analyzed using SPSS version 26. Regression analysis and ANOVA were used for inferential analysis. A P-value of ≤0.05 was considered significant.

Results and discussion: Among the 200 patients included in the study, the mean age of the study population was 56 years, and the majority of them were females (71%). The prevalence of albuminuria was found to be 44%. By using regression analysis, glycated hemoglobin (HbA1c; P=0.038) and systolic blood pressure (SBP; P=0.003) were found to be predictors of albuminuria. One way ANOVA revealed that there were significant associations between the albumin levels and HbA1c (P=0.004), SBP (P= 0.002), diastolic blood pressure (DBP; P=0.028), serum creatinine (Scr) (P=0.039), and glomerular filtration rate (GFR; P=0.013).

Conclusion: To the best of our knowledge, this is the first study from Fujairah emirate that explored the prevalence and predictors of albuminuria in type 2 DM patients. We found a high prevalence of albuminuria among type 2 DM patients. HbA1c and SBP directly contributed to albuminuria. To improve glycemic control, patients need to improve physical activity, reduce overweight and, adherence to medications that improve overall therapeutic outcomes.

Background: Diabetes Mellitus is a chronic health condition (long-lasting) due to inadequate control of blood levels of glucose. This study presents a prediction of Type 2 Diabetes Mellitus among women using various Machine Learning Algorithms deployed to predict the diabetic condition. A University of California Irvine Diabetes Mellitus Dataset posted in Kaggle was used for analysis.

Methods: The dataset included eight risk factors for Type 2 Diabetes Mellitus prediction, including Age, Systolic Blood Pressure, Glucose, Body Mass Index, Insulin, Skin Thickness, Diabetic Pedigree Function, and Pregnancy. R language was used for the data visualization, while the algorithms considered for the study are Logistic Regression, Support Vector Machines, Decision Trees and Extreme Gradient Boost. The performance analysis of these algorithms on various classification metrics is also presented here, considering the Area Under the Curve and Receiver Operating Characteristics score is the best for Extreme Gradient Boost with 85%, followed by Support Vector Machines and Decision Trees.

Results: The Logistic Regression is showing low performance. But the Decision Trees and Extreme Gradient Boost show promising performance against all the classification metrics. But the Support Vector Machines offers a lower support value; hence it cannot be claimed to be a good classifier. The model showed that the most significant predictors of Type 2 Diabetes Mellitus were strongly correlated with Glucose Levels and mediumly correlated with Body Mass Index, whereas Age, Skin Thickness, Systolic Blood Pressure, Insulin, Pregnancy, and Pedigree Function were less significant. This type of real-time analysis has proved that the symptoms of Type 2 Diabetes Mellitus in women fall entirely different compared to men, which highlights the importance of Glucose Levels and Body Mass Index in women.

Conclusion: The prediction of Type 2 Diabetes Mellitus helps public health professionals to help people by suggesting proper food intake and adjusting lifestyle activities with good fitness management in women to make glucose levels and body mass index controlled. Therefore, the healthcare systems should give special attention to diabetic conditions in women to reduce exacerbations of the disease and other associated symptoms. This work attempts to predict the occurrence of Type 2 Diabetes Mellitus among women on their behavioral and biological conditions.