Pub Date : 2024-09-03DOI: 10.1016/j.diabres.2024.111843
Aims
To investigate the efficacy and safety of extracorporeal shockwave therapy(ESWT) for diabetic foot ulcers(DFUs).
Methods
Search in PubMed, EMBASE, the Cochrane Controlled Register of Trials (CENTAL), and Web of Science for randomized controlled trials (RCTs) published before August 8, 2023. All identified studies were screened following the selection criteria. Finally, we employed the STATA 14.0 software for conducting a meta-analysis to evaluate the efficacy and safety of ESWT.
Results
A total of ten RCTs with moderate methodological quality were included for data analysis. The findings showed that ESWT was significantly associated with significantly complete healed ulcers (risk ratio [RR]: 1.57, 95 % confidence interval [CI]:1.26 to 1.95) and lower rate of unchanged ulcers (RR: 0.25, 95 %CI: 0.14 to 0.42) compared to controls. Subgroup analysis further revealed that ESWT was better than both hyperbaric oxygen therapy (HOT) and the standard of care (SOC). Moreover, ESWT also significantly improved the average transcutaneous partial oxygen pressure (TcPO2) (mean difference[MD]: 1.71, 95 %CI: 1.22 to 2.19, p < 0.001). However, the rate of ≥ 50 % improved ulcers and treatment-emergent adverse events (TEAEs) were not significantly different between the ESWT and controls.
Conclusions
ESWT has shown promising efficacy and a favorable safety profile in the treatment of DFUs.
目的:研究体外冲击波疗法(ESWT)治疗糖尿病足溃疡(DFUs)的有效性和安全性:在PubMed、EMBASE、Cochrane对照试验登记(CENTAL)和Web of Science中搜索2023年8月8日之前发表的随机对照试验(RCT)。我们按照筛选标准对所有确定的研究进行了筛选。最后,我们使用 STATA 14.0 软件进行了荟萃分析,以评估 ESWT 的有效性和安全性:结果:我们共纳入了 10 项方法学质量中等的 RCT 进行数据分析。结果显示,与对照组相比,ESWT 与溃疡明显完全愈合(风险比 [RR]:1.57,95% 置信区间 [CI]:1.26 至 1.95)和溃疡未愈合率较低(RR:0.25,95%CI:0.14 至 0.42)有显著相关性。分组分析进一步显示,ESWT 的效果优于高压氧疗法(HOT)和标准护理(SOC)。此外,ESWT 还能明显改善平均经皮氧分压(TcPO2)(平均差[MD]:1.71, 95 %CI: 1.22 to 2.19, p 结论:ESWT 在治疗 DFU 方面具有良好的疗效和安全性。
{"title":"Extracorporeal shock wave therapy (ESWT) favors healing of diabetic foot ulcers: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.diabres.2024.111843","DOIUrl":"10.1016/j.diabres.2024.111843","url":null,"abstract":"<div><h3>Aims</h3><p>To investigate the efficacy and safety of extracorporeal shockwave therapy(ESWT) for diabetic foot ulcers(DFUs).</p></div><div><h3>Methods</h3><p>Search in PubMed, EMBASE, the Cochrane Controlled Register of Trials (CENTAL), and Web of Science for randomized controlled trials (RCTs) published before August 8, 2023. All identified studies were screened following the selection criteria. Finally, we employed the STATA 14.0 software for conducting a <em>meta</em>-analysis to evaluate the efficacy and safety of ESWT.</p></div><div><h3>Results</h3><p>A total of ten RCTs with moderate methodological quality were included for data analysis. The findings showed that ESWT was significantly associated with significantly complete healed ulcers (risk ratio [RR]: 1.57, 95 % confidence interval [CI]:1.26 to 1.95) and lower rate of unchanged ulcers (RR: 0.25, 95 %CI: 0.14 to 0.42) compared to controls. Subgroup analysis further revealed that ESWT was better than both hyperbaric oxygen therapy (HOT) and the standard of care (SOC). Moreover, ESWT also significantly improved the average transcutaneous partial oxygen pressure (TcPO2) (mean difference[MD]: 1.71, 95 %CI: 1.22 to 2.19, p < 0.001). However, the rate of ≥ 50 % improved ulcers and treatment-emergent adverse events (TEAEs) were not significantly different between the ESWT and controls.</p></div><div><h3>Conclusions</h3><p>ESWT has shown promising efficacy and a favorable safety profile in the treatment of DFUs.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1016/j.diabres.2024.111840
Aim
We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality.
Methods
A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed.
Results
There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes.
Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors.
Conclusion
Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.
{"title":"Glucose levels at hospital admission are associated with 5 year mortality","authors":"","doi":"10.1016/j.diabres.2024.111840","DOIUrl":"10.1016/j.diabres.2024.111840","url":null,"abstract":"<div><h3>Aim</h3><p>We aimed to determine if hospital admission hyperglycaemia and hypoglycaemia are associated with increased long-term mortality.</p></div><div><h3>Methods</h3><p>A post-hoc analysis of data from a trial of glucose screening in the emergency department was conducted. Data were linked with a death registry up to 5 years after admission. The relationship between admission glucose and mortality was examined by cox regression. Further analyses of people who survived the admission and subsequent 28 days was performed.</p></div><div><h3>Results</h3><p>There were 131,322 patients, of whom 38,712 (29.5 %) died. Mean follow-up was 3·3 ± 1·5 years. Compared to the reference glucose band of 6·1-8·0 mmol/L, there was increased mortality in higher bands, reaching a hazard ratio (HR) of 1·44 (95 %CI 1·34-1·55, p < 0·001) for people with glucose > 20·0 mmol/L. The HR was 1·56 (95 %CI 1·46-1·68, p < 0·001) for people with glucose ≤ 4·0 mmol/L. Similar relationships were observed among 28-day survivors. The relationships were attenuated among people with known diabetes.</p><p>Among 4867 subjects with glucose ≥ 14·0 mmol/L, those diagnosed with diabetes during the admission had lower mortality compared to subjects where the diagnosis was not made (HR 0·53, 95 %CI 0·40-0·72, p < 0·001). This was attenuated among 28-day survivors.</p></div><div><h3>Conclusion</h3><p>Hyperglycaemia and hypoglycaemia on hospital admission are associated with increased long-term mortality.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1016/j.diabres.2024.111842
{"title":"International Diabetes Federation granted special consultative status with UN ECOSOC","authors":"","doi":"10.1016/j.diabres.2024.111842","DOIUrl":"10.1016/j.diabres.2024.111842","url":null,"abstract":"","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1016/j.diabres.2024.111841
Objective
To explore the relationship between changes in glycated hemoglobin (HbA1c) during the second and third trimesters and adverse pregnancy outcomes among women without hyperglycemia in pregnancy (HIP).
Research design and methods: A total of 1,057 pregnant women who underwent serum HbA1c and delivered at Women’s Hospital, Zhejiang University School of Medicine from May 2022 to March 2023, were included in this study. They were divided into four groups. Associations were evaluated using multivariate logistic regression analysis.
Results
In our study, an upward trend in HbA1c levels in the second trimester (HbA1c_S) and third trimester (HbA1c_T) among women without HIP was demonstrated. Multivariate logistics regression analysis showed significant associations: Pregnant women with HbA1c_S<5.5 %, HbA1c_T≥6.1 %, or with HbA1c_S≥5.5 %, HbA1c_T<6.1 % had a significant correlation with hypertensive disorders of pregnancy (HDP) (aOR:2.72, 95 %CI=1.24–5.97;aOR:2.59, 95 %CI=1.15–5.84). Furthermore, for each 1 % increase in the difference value of HbA1c between the second and third trimesters, the risk of HDP increased about 1.96 times, and the risk of delivering a large-for-gestational-age baby increased about 1.30 times.
Conclusion
Among pregnant women without HIP, elevated HbA1c levels in the second or third trimester are associated with increased risks of adverse pregnancy outcomes.
{"title":"Association between changes in glycosylated hemoglobin during the second and third trimesters and adverse pregnancy outcomes among women without hyperglycemia in pregnancy","authors":"","doi":"10.1016/j.diabres.2024.111841","DOIUrl":"10.1016/j.diabres.2024.111841","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the relationship between changes in glycated hemoglobin (HbA1c) during the second and third trimesters and adverse pregnancy outcomes among women without hyperglycemia in pregnancy (HIP).</p><p>Research design and methods: A total of 1,057 pregnant women who underwent serum HbA1c and delivered at Women’s Hospital, Zhejiang University School of Medicine from May 2022 to March 2023, were included in this study. They were divided into four groups. Associations were evaluated using multivariate logistic regression analysis.</p></div><div><h3>Results</h3><p>In our study, an upward trend in HbA1c levels in the second trimester (HbA1c_S) and third trimester (HbA1c_T) among women without HIP was demonstrated. Multivariate logistics regression analysis showed significant associations: Pregnant women with HbA1c_S<5.5 %, HbA1c_T≥6.1 %, or with HbA1c_S≥5.5 %, HbA1c_T<6.1 % had a significant correlation with hypertensive disorders of pregnancy (HDP) (aOR:2.72, 95 %CI=1.24–5.97;aOR:2.59, 95 %CI=1.15–5.84). Furthermore, for each 1 % increase in the difference value of HbA1c between the second and third trimesters, the risk of HDP increased about 1.96 times, and the risk of delivering a large-for-gestational-age baby increased about 1.30 times.</p></div><div><h3>Conclusion</h3><p>Among pregnant women without HIP, elevated HbA1c levels in the second or third trimester are associated with increased risks of adverse pregnancy outcomes.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-24DOI: 10.1016/j.diabres.2024.111839
Aims
To evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on Cystic Fibrosis Related Diabetes (CFRD) glycemic control and insulin treatment in patients with CFRD during clinical practice.
Methods
We carried out a retrospective observational study of 23 adult patients with CFRD who started treatment with ETI. They had, at least, one F508del mutation. Data were collected before ETI initiation and 3, 6, and 12 months after.
Results
Glycemic control measured by HbA1c significantly improved by 0.3 % (0.1–0.5) after 3 months of ETI therapy (p = 0.004) and kept this improvement during follow-up (p < 0.001). The proportion of patients needing multiple daily injections of insulin was reduced by 16 % (p = 0.023). Total daily insulin dose dropped by 0.12 (0.05–0.18) UI/kg/day (p < 0.001). Data derived from Flash Continuous Glucose Monitoring (CGM) for patients treated with insulin stayed unchanged after insulin reduction, except for a significant 8 % (0.3–15.6) increase in the Time In Tight Range (TITR) between 70 and 140 mg/dL (p = 0.043).
Conclusion
ETI therapy impacted CFRD in clinical practice reducing insulin needs and improving glycemic control measured by HbA1c and CGM. The improvements can be observed from the first 3 months of treatment.
{"title":"Impact of triple transmembrane regulator therapy on glucose metabolism in cystic fibrosis related diabetes during clinical practice","authors":"","doi":"10.1016/j.diabres.2024.111839","DOIUrl":"10.1016/j.diabres.2024.111839","url":null,"abstract":"<div><h3>Aims</h3><p>To evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on Cystic Fibrosis Related Diabetes (CFRD) glycemic control and insulin treatment in patients with CFRD during clinical practice.</p></div><div><h3>Methods</h3><p>We carried out a retrospective observational study of 23 adult patients with CFRD who started treatment with ETI. They had, at least, one F508del mutation. Data were collected before ETI initiation and 3, 6, and 12 months after.</p></div><div><h3>Results</h3><p>Glycemic control measured by HbA1c significantly improved by 0.3 % (0.1–0.5) after 3 months of ETI therapy (p = 0.004) and kept this improvement during follow-up (p < 0.001). The proportion of patients needing multiple daily injections of insulin was reduced by 16 % (p = 0.023). Total daily insulin dose dropped by 0.12 (0.05–0.18) UI/kg/day (p < 0.001). Data derived from Flash Continuous Glucose Monitoring (CGM) for patients treated with insulin stayed unchanged after insulin reduction, except for a significant 8 % (0.3–15.6) increase in the Time In Tight Range (TITR) between 70 and 140 mg/dL (p = 0.043).</p></div><div><h3>Conclusion</h3><p>ETI therapy impacted CFRD in clinical practice reducing insulin needs and improving glycemic control measured by HbA1c and CGM. The improvements can be observed from the first 3 months of treatment.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.diabres.2024.111833
The global rise in diabetes prevalence poses a significant challenge to healthcare providers, stimulating interest in digital interventions such as educational games. However, the impact and availability of research-developed diabetes games remain uncertain. This scoping review aimed to provide a comprehensive overview of serious games for diabetes, encompassing their availability, characteristics and health effects. Through an electronic search in multiple databases, a total of 21 articles addressing 23 games were included in the literature review. The majority of these games were inaccessible outside of research settings, despite demonstrating positive effects on various aspects of diabetes management, including knowledge, physical activity, self-management, mental well-being, and HbA1c levels. Most games were designed for mobile phones, targeting both children and adults. A subsequent app store search revealed 13 additional diabetes games, however nearly none (7.7%) of these underwent research scrutiny, leaving their expected effects uncertain. The disparity between evidence-based games and those available in app stores underscores the need for bridging this gap to ensure the availability of effective digital games for diabetes management worldwide.
{"title":"Serious digital games for diabetes Mellitus: A scoping review of its current State, Accessibility, and functionality for patients and healthcare providers","authors":"","doi":"10.1016/j.diabres.2024.111833","DOIUrl":"10.1016/j.diabres.2024.111833","url":null,"abstract":"<div><p>The global rise in diabetes prevalence poses a significant challenge to healthcare providers, stimulating interest in digital interventions such as educational games. However, the impact and availability of research-developed diabetes games remain uncertain. This scoping review aimed to provide a comprehensive overview of serious games for diabetes, encompassing their availability, characteristics and health effects. Through an electronic search in multiple databases, a total of 21 articles addressing 23 games were included in the literature review. The majority of these games were inaccessible outside of research settings, despite demonstrating positive effects on various aspects of diabetes management, including knowledge, physical activity, self-management, mental well-being, and HbA1c levels. Most games were designed for mobile phones, targeting both children and adults. A subsequent app store search revealed 13 additional diabetes games, however nearly none (7.7%) of these underwent research scrutiny, leaving their expected effects uncertain. The disparity between evidence-based games and those available in app stores underscores the need for bridging this gap to ensure the availability of effective digital games for diabetes management worldwide.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168822724007435/pdfft?md5=7c7a406cb1bad49c21d13398410242fa&pid=1-s2.0-S0168822724007435-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.diabres.2024.111832
Background
The aim of the study was to analyze the real-world performance of MiniMed 780G (MM780G) Advanced Hybrid Closed Loop (AHCL) system users from Poland (PL) and compare it to the European region excluding Poland (EU-PL) in order to identify factors contributing to potential differences. The former achieved some of the best Time in Range (TIR) results globally using this technology.
Methods
CareLink Personal data uploaded by MM780G system users from August 2020 to December 2022 were analyzed.
Results
The Polish users (N=1304) on average reached to TIR of 79.1 ± 8.7 % (vs 73.0 ± 10.0 % for EU-PL, N=55659), a TBR<54 mg/dL of 0.6 ± 0.7 % (vs 0.4 ± 0.6 %) and a TBR<70 mg/dL of 2.9 ± 2.1 % (vs 2.1 ± 1.8 %). The adoption rate of optimal settings (i.e, GT=100 mg/dL, AIT=2hr) in PL was high (19.7 % vs 6.3 %), and filtering on optimal setting users led to less pronounced differences in glycemic control between PL and EU-PL. A univariable analysis with post-AHCL TIR showed that geography itself (PL vs EU-PL) is not a significant contributor to a high post-AHCL TIR (p = 0.15), and that much of the Polish post-AHCL TIR can be explained by the high pre-AHCL TIR.
Conclusion
The Polish MM780G users achieved better glycemic control than the general European population (excluding Poland). This is largely attributable to the adoption of optimal settings in Poland and the already high glycemic outcomes at system start. As these characteristics can be implemented elsewhere, we believe this outstanding result can be obtained in other countries as well.
{"title":"Excellence in the management of Advanced Hybrid Closed-Loop Systems: Lessons from the Polish cohort","authors":"","doi":"10.1016/j.diabres.2024.111832","DOIUrl":"10.1016/j.diabres.2024.111832","url":null,"abstract":"<div><h3>Background</h3><p>The aim of the study was to analyze the real-world performance of MiniMed 780G (MM780G) Advanced Hybrid Closed Loop (AHCL) system users from Poland (PL) and compare it to the European region excluding Poland (EU-PL) in order to identify factors contributing to potential differences. The former achieved some of the best Time in Range (TIR) results globally using this technology.</p></div><div><h3>Methods</h3><p>CareLink Personal data uploaded by MM780G system users from August 2020 to December 2022 were analyzed<strong>.</strong></p></div><div><h3>Results</h3><p>The Polish users (N=1304) on average reached to TIR of 79.1 ± 8.7 % (vs 73.0 ± 10.0 % for EU-PL, N=55659), a TBR<54 mg/dL of 0.6 ± 0.7 % (vs 0.4 ± 0.6 %) and a TBR<70 mg/dL of 2.9 ± 2.1 % (vs 2.1 ± 1.8 %). The adoption rate of optimal settings (i.e, GT=100 mg/dL, AIT=2hr) in PL was high (19.7 % vs 6.3 %), and filtering on optimal setting users led to less pronounced differences in glycemic control between PL and EU-PL. A univariable analysis with post-AHCL TIR showed that geography itself (PL vs EU-PL) is not a significant contributor to a high post-AHCL TIR (p = 0.15), and that much of the Polish post-AHCL TIR can be explained by the high pre-AHCL TIR.</p></div><div><h3>Conclusion</h3><p>The Polish MM780G users achieved better glycemic control than the general European population (excluding Poland). This is largely attributable to the adoption of optimal settings in Poland and the already high glycemic outcomes at system start. As these characteristics can be implemented elsewhere, we believe this outstanding result can be obtained in other countries as well.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0168822724007423/pdfft?md5=68c1ce921e597f02849f34399c99e5b6&pid=1-s2.0-S0168822724007423-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.diabres.2024.111838
Background
Gestational Diabetes Mellitus (GDM) poses significant risks to maternal and fetal health, yet its precise etiology remains unclear. Observational studies have demonstrated a link between specific inflammatory cytokines and the occurrence of GDM, but the causal relationships remain uncertain.
Methods
Utilizing publicly accessible genetic data, we performed a bidirectional two-sample mendelian randomization (MR) analysis to elucidate the causal association between 91 inflammatory cytokines and GDM. Sensitivity analysis was carried out to evaluate the robustness, heterogeneity, and potential presence of horizontal pleiotropy within the results.
Results
Elevated levels of Interleukin-7 (IL7) and Neurturin (NRTN) (OR=1.104, 95 % CI=1.003–1.216, p = 0.042; OR=1.102, 95 % CI=1.023–1.187, p = 0.010), along with decreased levels of Glial cell line-derived neurotrophic factor (GDNF), Interleukin-12 subunit beta (IL12β), and Interleukin-20 (IL20) (OR=0.911, 95 % CI=0.849–0.979, p = 0.010;OR=0.955, 95 % CI=0.916–0.996, p = 0.033; OR=0.892, 95 % CI=0.819–0.971, p = 0.008), are associated with increased GDM risk. Additionally, GDM occurrence correlates with increased Matrix metalloproteinase-10 (MMP-10) and decreased Interleukin-20 receptor subunit alpha (IL-20Rα) levels (OR=1.042, 95 % CI=1.002–1.084, p = 0.038; OR=0.949, 95 % CI=0.909–0.992, p = 0.021). Sensitivity analyses detected no significant heterogeneity or pleiotropy.
Conclusion
This study has clarified the causal link between inflammatory cytokines and GDM, thereby enhancing our comprehension of the potential mechanisms involved in GDM pathogenesis. These findings offer new insights into the etiology, diagnosis, and therapeutic strategies for GDM.
{"title":"The causal relationship between 91 inflammatory cytokines and Gestational Diabetes Mmellitus: A bidirectional two-sample Mendelian randomization study","authors":"","doi":"10.1016/j.diabres.2024.111838","DOIUrl":"10.1016/j.diabres.2024.111838","url":null,"abstract":"<div><h3>Background</h3><p>Gestational Diabetes Mellitus (GDM) poses significant risks to maternal and fetal health, yet its precise etiology remains unclear. Observational studies have demonstrated a link between specific inflammatory cytokines and the occurrence of GDM, but the causal relationships remain uncertain.</p></div><div><h3>Methods</h3><p>Utilizing publicly accessible genetic data, we performed a bidirectional two-sample mendelian randomization (MR) analysis to elucidate the causal association between 91 inflammatory cytokines and GDM. Sensitivity analysis was carried out to evaluate the robustness, heterogeneity, and potential presence of horizontal pleiotropy within the results.</p></div><div><h3>Results</h3><p>Elevated levels of Interleukin-7 (IL7) and Neurturin (NRTN) (OR=1.104, 95 % CI=1.003–1.216, <em>p</em> = 0.042; OR=1.102, 95 % CI=1.023–1.187, <em>p</em> = 0.010), along with decreased levels of Glial cell line-derived neurotrophic factor (GDNF), Interleukin-12 subunit beta (IL12β), and Interleukin-20 (IL20) (OR=0.911, 95 % CI=0.849–0.979, <em>p</em> = 0.010;OR=0.955, 95 % CI=0.916–0.996, <em>p</em> = 0.033; OR=0.892, 95 % CI=0.819–0.971, <em>p</em> = 0.008), are associated with increased GDM risk. Additionally, GDM occurrence correlates with increased Matrix metalloproteinase-10 (MMP-10) and decreased Interleukin-20 receptor subunit alpha (IL-20Rα) levels (OR=1.042, 95 % CI=1.002–1.084, <em>p</em> = 0.038; OR=0.949, 95 % CI=0.909–0.992, <em>p</em> = 0.021). Sensitivity analyses detected no significant heterogeneity or pleiotropy.</p></div><div><h3>Conclusion</h3><p>This study has clarified the causal link between inflammatory cytokines and GDM, thereby enhancing our comprehension of the potential mechanisms involved in GDM pathogenesis. These findings offer new insights into the etiology, diagnosis, and therapeutic strategies for GDM.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.diabres.2024.111815
Type 2 diabetes mellitus (T2DM) and pre-diabetes (pre-DM) are significant health concerns in Pakistan. This systematic review and meta-analysis estimate the prevalence of T2DM and pre-DM, assessing regional, gender, and urban–rural differences. We searched PubMed, Scopus, Cochrane, and PakMediNet databases, identifying 3478 articles. After screening, 17 studies from 1995 to 2018 were included. The pooled prevalence of T2DM and pre-DM in Pakistan was found to be 10.0 % and 11.0 %, respectively. This equates to approximately 24 million individuals with T2DM and 26 million with pre-DM, totaling 50 million affected. Rural areas showed higher T2DM prevalence post-2000, with an odds ratio (OR) of 1.25 (95 % CI: 0.73 to 2.14). Gender analysis revealed a slightly higher, though statistically insignificant, prevalence of T2DM in females and a significantly higher prevalence of pre-DM in males (OR: 0.79, 95 % CI: 0.63 to 0.98). Regionally, Punjab had the highest T2DM prevalence (16 %), followed by Baluchistan (15 %), Sindh (14 %), and Khyber Pakhtunkhwa (KPK) (11 %). There is a substantial burden of T2DM and pre-DM in Pakistan, with significant regional and gender differences. Targeted interventions and resource allocation are needed to address the rising prevalence of diabetes, focusing on early detection and lifestyle modifications.
{"title":"Nationwide prevalence of type 2 diabetes mellitus and pre-diabetes in Pakistan: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.diabres.2024.111815","DOIUrl":"10.1016/j.diabres.2024.111815","url":null,"abstract":"<div><p>Type 2 diabetes mellitus (T2DM) and pre-diabetes (pre-DM) are significant health concerns in Pakistan. This systematic review and <em>meta</em>-analysis estimate the prevalence of T2DM and pre-DM, assessing regional, gender, and urban–rural differences. We searched PubMed, Scopus, Cochrane, and PakMediNet databases, identifying 3478 articles. After screening, 17 studies from 1995 to 2018 were included. The pooled prevalence of T2DM and pre-DM in Pakistan was found to be 10.0 % and 11.0 %, respectively. This equates to approximately 24 million individuals with T2DM and 26 million with pre-DM, totaling 50 million affected. Rural areas showed higher T2DM prevalence post-2000, with an odds ratio (OR) of 1.25 (95 % CI: 0.73 to 2.14). Gender analysis revealed a slightly higher, though statistically insignificant, prevalence of T2DM in females and a significantly higher prevalence of pre-DM in males (OR: 0.79, 95 % CI: 0.63 to 0.98). Regionally, Punjab had the highest T2DM prevalence (16 %), followed by Baluchistan (15 %), Sindh (14 %), and Khyber Pakhtunkhwa (KPK) (11 %). There is a substantial burden of T2DM and pre-DM in Pakistan, with significant regional and gender differences. Targeted interventions and resource allocation are needed to address the rising prevalence of diabetes, focusing on early detection and lifestyle modifications.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-21DOI: 10.1016/j.diabres.2024.111837
The pathogenesis of type 2 diabetes (T2D) involves dysfunction in multiple organs, including the liver, muscle, adipose tissue, and pancreas, leading to insulin resistance and β cell failure. Recent studies highlight the significant role of extracellular vesicles (EVs) in mediating inter-organ communication in T2D. This review investigates the role of EVs, focusing on their presence and biological significance in human plasma and tissues affected by T2D. We explore specific EV cargo, such as miRNAs and proteins, which affect insulin signaling and glucose metabolism, emphasizing their potential as biomarkers. By highlighting the diagnostic and therapeutic potential of EVs, we aim to provide new insights into their role in early detection, disease monitoring, and innovative treatment strategies for T2D.
{"title":"The interplay of extracellular vesicles in the pathogenesis of metabolic impairment and type 2 diabetes","authors":"","doi":"10.1016/j.diabres.2024.111837","DOIUrl":"10.1016/j.diabres.2024.111837","url":null,"abstract":"<div><p>The pathogenesis of type 2 diabetes (T2D) involves dysfunction in multiple organs, including the liver, muscle, adipose tissue, and pancreas, leading to insulin resistance and β cell failure. Recent studies highlight the significant role of extracellular vesicles (EVs) in mediating inter-organ communication in T2D. This review investigates the role of EVs, focusing on their presence and biological significance in human plasma and tissues affected by T2D. We explore specific EV cargo, such as miRNAs and proteins, which affect insulin signaling and glucose metabolism, emphasizing their potential as biomarkers. By highlighting the diagnostic and therapeutic potential of EVs, we aim to provide new insights into their role in early detection, disease monitoring, and innovative treatment strategies for T2D.</p></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}