Direzione Scientifica, S. Squatrito, Catania Direttore, Responsabile Stefano Melloni, Maurizio Sabrina Scilletta, D. Marco, Nicoletta Miano, Agnese Filippello, S. D. Mauro, Alessandra Scamporrino, Marco Musmeci, Giuseppe Coppolino, F. di, Giacomo Barbagallo, Giosiana Bosco, Roberto Scicali, S. Piro, Francesco Purrello, A. Pino
The classic description of diabetic kidney disease (DKD) involves progressive stages of glomerular hyperfiltration, microalbuminuria, and a decline in the estimated glomerular filtration rate (eGFR). However, large studies have revealed that eGFR decline may also occur independently from development of albuminuria. This concept led to the identification of a new phenotype: non-albuminuric DKD, whose pathogenesis is still unknown and data in literature are still controversial. This review is focused on cardiovascular risk profile and therapeutical implication of this new DKD phenotype.
{"title":"Update sulla malattia renale diabetica (DKD): focus sulla DKD non albuminurica e il rischio cardiovascolare","authors":"Direzione Scientifica, S. Squatrito, Catania Direttore, Responsabile Stefano Melloni, Maurizio Sabrina Scilletta, D. Marco, Nicoletta Miano, Agnese Filippello, S. D. Mauro, Alessandra Scamporrino, Marco Musmeci, Giuseppe Coppolino, F. di, Giacomo Barbagallo, Giosiana Bosco, Roberto Scicali, S. Piro, Francesco Purrello, A. Pino","doi":"10.30682/ildia2304a","DOIUrl":"https://doi.org/10.30682/ildia2304a","url":null,"abstract":"The classic description of diabetic kidney disease (DKD) involves progressive stages of glomerular hyperfiltration, microalbuminuria, and a decline in the estimated glomerular filtration rate (eGFR). However, large studies have revealed that eGFR decline may also occur independently from development of albuminuria. This concept led to the identification of a new phenotype: non-albuminuric DKD, whose pathogenesis is still unknown and data in literature are still controversial. This review is focused on cardiovascular risk profile and therapeutical implication of this new DKD phenotype.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139618634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The adipose organ is composed by two types of tissue: the white adipose tissue and the brown adipose tissue. Recently, it has been classified as a real endocrine organ whose dysfunction is involved in different diseases, mainly obesity and type 2 diabetes. The adipose tissues produce specific citokines named adipokines (the one from white adipose tissue) and batokines (the one from brown adipose tissue). They have opposite roles but mice and human data have demonstrated their capacity to convert to each other in response to the physio or pathophysiologic condition. This process is called transdifferentiation. We here aim to retrace the adipose organ history from physiology to physiopathology, to provide therapeutic perspectives for the prevention and treatment of its two main related diseases: obesity and type 2 diabetes.
{"title":"Le citochine organo-specifiche nel diabete: aggiornamenti e prospettive future","authors":"F. Cinti, A. Giaccari","doi":"10.30682/ildia2302a","DOIUrl":"https://doi.org/10.30682/ildia2302a","url":null,"abstract":"The adipose organ is composed by two types of tissue: the white adipose tissue and the brown adipose tissue. Recently, it has been classified as a real endocrine organ whose dysfunction is involved in different diseases, mainly obesity and type 2 diabetes. The adipose tissues produce specific citokines named adipokines (the one from white adipose tissue) and batokines (the one from brown adipose tissue). They have opposite roles but mice and human data have demonstrated their capacity to convert to each other in response to the physio or pathophysiologic condition. This process is called transdifferentiation. \u0000We here aim to retrace the adipose organ history from physiology to physiopathology, to provide therapeutic perspectives for the prevention and treatment of its two main related diseases: obesity and type 2 diabetes.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116825143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valentina Annamaria Genchi, Celeste Lauriola, Angelo Cignarelli, F. Giorgino
Insulin regulates whole-body energy and lipid metabolism by activating the insulin receptor (INSR) consisting in two isoforms: INSR-A expressed in less-differentiated cells with prominent mitogenic effect; INSR-B mostly expressed in adult tissues with pronounced metabolic properties. It is well known that tissue-specific variation in INSR-A/INSR-B ratio may favour the development of metabolic abnormalities. Herein, we examine the role of insulin/INSR signalling in the regulation of several aspects of adipose tissue physiology and the effects of insulin mimetics on adiposity.
{"title":"Ruolo dell’insulina e del recettore insulinico nel tessuto adiposo","authors":"Valentina Annamaria Genchi, Celeste Lauriola, Angelo Cignarelli, F. Giorgino","doi":"10.30682/ildia2302g","DOIUrl":"https://doi.org/10.30682/ildia2302g","url":null,"abstract":"Insulin regulates whole-body energy and lipid metabolism by activating the insulin receptor (INSR) consisting in two isoforms: INSR-A expressed in less-differentiated cells with prominent mitogenic effect; INSR-B mostly expressed in adult tissues with pronounced metabolic properties. It is well known that tissue-specific variation in INSR-A/INSR-B ratio may favour the development of metabolic abnormalities. Herein, we examine the role of insulin/INSR signalling in the regulation of several aspects of adipose tissue physiology and the effects of insulin mimetics on adiposity.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129389947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present review will depict the role and the boundaries of a relatively new profession, entering the world of diabetes and surroundings, the Counselor. Originally, only large companies were hiring Counselors to improve inter-personal relationships, and approach and resolve human resources problems. More recently, the Counselor was introduced in the Health environment with the scope of reinforcing relationship among patients and physicians, improve physician to patient communication but also improving physician to physician relationships and in general communication among health workers. Specific examples of fields of action of Counselors will be presented, with a specific focus on the interaction between Counselor and patients with type 1 and type 2 diabetes. In conclusion, the wide array of potential applications of Counselors will make this new profession particularly appealing for the Diabetes Team World-wide.
{"title":"Il Counselor nel team diabetologico","authors":"L. Luzi, Mery Azman","doi":"10.30682/ildia2302c","DOIUrl":"https://doi.org/10.30682/ildia2302c","url":null,"abstract":"The present review will depict the role and the boundaries of a relatively new profession, entering the world of diabetes and surroundings, the Counselor. Originally, only large companies were hiring Counselors to improve inter-personal relationships, and approach and resolve human resources problems. More recently, the Counselor was introduced in the Health environment with the scope of reinforcing relationship among patients and physicians, improve physician to patient communication but also improving physician to physician relationships and in general communication among health workers. Specific examples of fields of action of Counselors will be presented, with a specific focus on the interaction between Counselor and patients with type 1 and type 2 diabetes. In conclusion, the wide array of potential applications of Counselors will make this new profession particularly appealing for the Diabetes Team World-wide.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123651780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Type 2 diabetes (T2D) is a multifactorial disease with multiple etiology, characterized by chronically elevated blood glucose levels. Although the reduction of pancreatic β-cell functional mass, associated or not with peripheral insulin resistance, is recognized as the main etiopathogenetic factor leading to the onset of T2D, the dysregulation of glucose metabolism is actually the result of multi-organs alterations, including skeletal muscle and adipose tissue dysfunction, hepatic insulin resistance, and incretin axis defects. Furthermore, the chronic elevation of blood glucose levels leads to the onset of systemic complications affecting many organs and tissues. Therefore, T2D is a multi-organ disease and future anti-diabetic drugs can no longer be considered simple hypoglycemic drugs: they should at least be able to restore β-cell functional mass, reduce peripheral insulin resistance, ensure adequate weight loss (when necessary), and exert cardio- and nephro-protective effects. In light of this, irisin, a hormone secreted by skeletal muscle in response to physical activity, should be remarked as a new promising anti-diabetes molecule, being able to exert beneficial effects on the various organs involved in the pathogenesis of T2D, in particular on pancreatic β-cells, liver, skeletal muscle, adipose tissue, and many of the organs affected by diabetes complications.
{"title":"Irisina: un singolo ormone, molti cross-talk","authors":"A. Natalicchio, N. Marrano, F. Giorgino","doi":"10.30682/ildia2302b","DOIUrl":"https://doi.org/10.30682/ildia2302b","url":null,"abstract":"Type 2 diabetes (T2D) is a multifactorial disease with multiple etiology, characterized by chronically elevated blood glucose levels. Although the reduction of pancreatic β-cell functional mass, associated or not with peripheral insulin resistance, is recognized as the main etiopathogenetic factor leading to the onset of T2D, the dysregulation of glucose metabolism is actually the result of multi-organs alterations, including skeletal muscle and adipose tissue dysfunction, hepatic insulin resistance, and incretin axis defects. Furthermore, the chronic elevation of blood glucose levels leads to the onset of systemic complications affecting many organs and tissues. Therefore, T2D is a multi-organ disease and future anti-diabetic drugs can no longer be considered simple hypoglycemic drugs: they should at least be able to restore β-cell functional mass, reduce peripheral insulin resistance, ensure adequate weight loss (when necessary), and exert cardio- and nephro-protective effects. In light of this, irisin, a hormone secreted by skeletal muscle in response to physical activity, should be remarked as a new promising anti-diabetes molecule, being able to exert beneficial effects on the various organs involved in the pathogenesis of T2D, in particular on pancreatic β-cells, liver, skeletal muscle, adipose tissue, and many of the organs affected by diabetes complications.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126114572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Geremia B. Bolli, Francesca Porcellati, P. Lucidi, Carmine G. Fanelli
The DCCT (Diabetes Control Complication Trials) has conclusively demonstrated in 1993 that good glycaemic control prevents the micro-angiopathy caused by chronic hyperglycaemia in T1DM. The subsequent follow-up study EDIC (Epidemiology of Diabetes Interventions and Complications) has demonstrated similar results for macro-angiopathy. Taken together, DCCT and EDIC strongly indicate the need for aggressive treatment of T1DM with intensive therapy to target near-normoglycaemia since clinical onset of T1DM to prevent long-term micro- and macro-vascular complications. Today and in the years to come, this message remains and will remain as fundamental as it was 30 years ago.
{"title":"Trent’anni fa i risultati del DCCT: cosa significarono allora e cosa rappresentano oggi","authors":"Geremia B. Bolli, Francesca Porcellati, P. Lucidi, Carmine G. Fanelli","doi":"10.30682/ildia2302d","DOIUrl":"https://doi.org/10.30682/ildia2302d","url":null,"abstract":"The DCCT (Diabetes Control Complication Trials) has conclusively demonstrated in 1993 that good glycaemic control prevents the micro-angiopathy caused by chronic hyperglycaemia in T1DM. The subsequent follow-up study EDIC (Epidemiology of Diabetes Interventions and Complications) has demonstrated similar results for macro-angiopathy. Taken together, DCCT and EDIC strongly indicate the need for aggressive treatment of T1DM with intensive therapy to target near-normoglycaemia since clinical onset of T1DM to prevent long-term micro- and macro-vascular complications. Today and in the years to come, this message remains and will remain as fundamental as it was 30 years ago. \u0000","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121690287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gli interventi di prevenzione del diabete gestazionale sono convenienti anche da un punto di vista di economia sanitaria","authors":"Marta Letizia Hribal","doi":"10.30682/ildia2302f","DOIUrl":"https://doi.org/10.30682/ildia2302f","url":null,"abstract":"","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129158711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The artificial pancreas or automated insulin delivery (AID) system is an important step forward in the treatment of diabetes. Besides commercial AID systems, open-source automated insulin delivery systems (opensource-AID), known more colloquially as “Do-it-Yourself Artificial Pancreas Systems” (DIY APS) have become available. They couple algorithms developed by patients with diabetes, with commercially available and regulatory-approved insulin pumps and continuous glucose monitoring (CGM) sensors. These closed loop systems, are categorized by the technology and algorithm they incorporate (OpenAPS, Android APS or Loop). Until now only one open-source algorithm has been approved by Food and Drug Administration. Different studies, observational, real time and randomized-controlled have shown that AID open-source systems can improve metabolic control and quality of life in patients with diabetes, while decreasing the burden of diabetes management. Aim of this paper is to summarize data from the literature and to reason about the implications that the arrival of this new technique will have for patients and caregivers.
{"title":"Sistemi di somministrazione insulinica automatizzata open source: a che punto siamo?","authors":"Daniela Bruttomesso, Federico Boscari","doi":"10.30682/ildia2302h","DOIUrl":"https://doi.org/10.30682/ildia2302h","url":null,"abstract":"\u0000The artificial pancreas or automated insulin delivery (AID) system is an important step forward in the treatment of diabetes. Besides commercial AID systems, open-source automated insulin delivery systems (opensource-AID), known more colloquially as “Do-it-Yourself Artificial Pancreas Systems” (DIY APS) have become available. They couple algorithms developed by patients with diabetes, with commercially available and regulatory-approved insulin pumps and continuous glucose monitoring (CGM) sensors. These closed loop systems, are categorized by the technology and algorithm they incorporate (OpenAPS, Android APS or Loop). Until now only one open-source algorithm has been approved by Food and Drug Administration. \u0000Different studies, observational, real time and randomized-controlled have shown that AID open-source systems can improve metabolic control and quality of life in patients with diabetes, while decreasing the burden of diabetes management. \u0000Aim of this paper is to summarize data from the literature and to reason about the implications that the arrival of this new technique will have for patients and caregivers.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133746551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/aim: this editorial is aimed at providing a reference for the medical nutritional therapy (MNT) in patients with type 2 diabetes, as recommended by the new Italian guidelines for the treatment of type 2 diabetes and its 2023-Update. Methods and results: the present paper re¬vised the recently published Italian guidelines for the treatment of type 2 diabetes (outpatients) and its update, either in primary care or specialist referral. The guideline has been developed following the methods described in the Manual of the National Guideline System (http://www.snlg-iss.it) by a panel nominated by the Società Italiana di Diabetologia (SID) and Associazione Medici Diabetologi (AMD). Available literature on nutritional therapy showed a greater efficacy of: 1) MNT vs. unstructured nutritional advices, 2) Mediterranean diet vs. other dietary approaches, and the use of low- vs. high-glycemic index nutrients in reducing HbA1c and body weight. Conclusions: the present paper illustrates the recommendations of the Italian guidelines (and its 2023-update) for the treatment of type 2 diabetes on medical nutritional therapy. In synthesis, the panel suggests a structured medical therapy, balanced diet (Mediterranean), and the use of low-, rather than high-glycemic index nutrients due to the improvement of glycemic control and body weight.
{"title":"Le raccomandazioni nutrizionali alla luce delle nuove linee guida italiane (e degli aggiornamenti) per il trattamento del diabete di tipo 2","authors":"M. Monami","doi":"10.30682/ildia2301d","DOIUrl":"https://doi.org/10.30682/ildia2301d","url":null,"abstract":"Background/aim: this editorial is aimed at providing a reference for the medical nutritional therapy (MNT) in patients with type 2 diabetes, as recommended by the new Italian guidelines for the treatment of type 2 diabetes and its 2023-Update. Methods and results: the present paper re¬vised the recently published Italian guidelines for the treatment of type 2 diabetes (outpatients) and its update, either in primary care or specialist referral. The guideline has been developed following the methods described in the Manual of the National Guideline System (http://www.snlg-iss.it) by a panel nominated by the Società Italiana di Diabetologia (SID) and Associazione Medici Diabetologi (AMD). Available literature on nutritional therapy showed a greater efficacy of: 1) MNT vs. unstructured nutritional advices, 2) Mediterranean diet vs. other dietary approaches, and the use of low- vs. high-glycemic index nutrients in reducing HbA1c and body weight. \u0000Conclusions: the present paper illustrates the recommendations of the Italian guidelines (and its 2023-update) for the treatment of type 2 diabetes on medical nutritional therapy. In synthesis, the panel suggests a structured medical therapy, balanced diet (Mediterranean), and the use of low-, rather than high-glycemic index nutrients due to the improvement of glycemic control and body weight.","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131478714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effetti di due diete isocaloriche in pazienti con diabete di tipo 2","authors":"","doi":"10.30682/ildia2301e","DOIUrl":"https://doi.org/10.30682/ildia2301e","url":null,"abstract":"","PeriodicalId":119243,"journal":{"name":"Il Diabete","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115320719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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