Journal of Diabetes and Metabolic Disorders最新文献

Diabetes mellitus (DM) is a common but complicated metabolic disease that causes hyperglycemia for a long time. It may cause serious health problems, such as poor wound healing. The complex biology of diabetic wound healing is reviewed here, with particular attention paid to the interactions between neuropathy, inadequate angiogenesis, metabolic dysfunctions, and chronic inflammation. Diabetes affects approximately 537 million individuals globally, and as the disease becomes more common, new treatment methods for chronic wounds are required. Reduced blood flow, sensory loss, and an insufficient inflammatory response are some of the variables that combine to cause persistent diabetes ulcers and often impede the healing process. There is major health issues associated with these ulcers, such as infections, gangrene formations, and even limb loss. Recent developments in the molecular processes of diabetic wound healing have provided important new information on the function of metabolic imbalances, the dysregulation of inflammatory pathways, and polymicrobial infections in tissue repair. This article discusses contemporary therapy strategies, which range from traditional wound care procedures to cutting-edge interventions including growth factor therapies and bioengineered skin replacements. To improve wound healing in diabetes patients, we want to provide researchers and physicians with useful information on possible intervention targets and future approaches by combining the most recent research results. Finally, a better comprehension of these intricate relationships might result in improved patient outcomes and a higher standard of living for those with diabetic wounds.

Diabetes mellitus is one of the most common chronic diseases, with a global distribution. Its prevalence is constantly increasing, along with the rising incidence of diabetes-related complications such as diabetic nephropathy, neuropathy, and retinopathy. MicroRNAs are endogenous, non-coding RNAs that regulate gene expression at the post-transcriptional level. Evidence suggests that altered microRNA expression has been implicated in various human disorders, including diabetes mellitus. Dysregulated expression of microRNAs leads to insulin resistance, causing diabetes mellitus and its associated complications. Moreover, other non-coding RNAs, such as long non-coding RNAs and circular RNAs, along with epigenetic factors and altered gut microbiota, contribute to disease development. Because of the stability of non-coding RNAs in circulation, they have the potential to be used as biomarkers for diagnosis and therapeutic implications. Evidence suggests that a myriad of factors are involved; hence, a collective approach involving non-coding RNAs, epigenetic factors, and gut microbiota could provide the best clinical outcomes for diabetes patients.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01591-y.

Objectives: The COVID-19 pandemic is one of the important challenges for health systems in various societies which results in high mortality. The present study aimed to investigate the association between the severity of COVID-19 and dietary patterns in diabetic and non-diabetic patients.

Methods: A total of 218 subjects (108 patients in the diabetic group and 110 participants in the non-diabetic group) participated in the present cross-sectional study. Demographic data, COVID-19 outcomes, and biochemical variables were gathered based on the medical records in the hospital. The dietary intake of participants was assessed using a 168-item food frequency questionnaire (FFQ). A multivariate regression test was carried out to determine the association between dietary patterns and severity of COVID-19. All of the statistical analyses were conducted by SPSS version 21.

Results: We determined three major dietary patterns including Healthy, Unhealthy, and Traditional dietary patterns in the current study. Statistical analysis indicated that there was a significant inverse association between Healthy dietary pattern and the severity of disease in the diabetic group (OR:0.75, 95%CI:0.62-0.89), while adherence to an Unhealthy dietary pattern increased the severity of COVID-19 in diabetic (OR:1.94, 95%CI:1.56-2.63), and non-diabetic (OR:1.92, 95%CI:1.27-3.54), groups. In addition, there was an indirect significant association between length of hospitalization and Healthy dietary pattern (Beta: -0.253, P: 0.008). However, statistical analysis didn't demonstrate a substantial relationship between dietary patterns and inflammatory variables.

Conclusion: According to the findings of the current study higher adherence to a Healthy dietary pattern had beneficial effects on the severity of COVID-19, but Unhealthy dietary patterns exacerbate the situation of patients infected with coronavirus SARS-CoV-2.

Objectives: To examine the association between tea consumption, mental health and sleep status in female patients with type 2 diabetes.

Methods: This cross-sectional study was conducted on 230 women with type 2 diabetes. All participants completed a sociodemographic questionnaire, a physical activity record, and a food frequency questionnaire to determine dietary intake and tea consumption. To evaluate sleep status and mental health, the Pittsburgh Sleep Quality Index and Depression, Anxiety and Stress Scale were completed by participants, respectively. Anthropometric measures and biochemical assessments were also recorded.

Results: The mean age and BMI of participants was 59.9 ± 9.20 years and 29.31 ± 4.52 kg/m², respectively. There was a significant association between sleep duration at night and tertiles of tea intake (P = 0.006). Furthermore, we found a significant association between sleep latency and tertiles of tea intake (P = 0.042). There was a significant positive association between amounts of tea intake and sleep latency in both crude (B; 0.023; SE: 0.009; P-value: 0.015) and adjusted models (highly adjusted model: B; 0.024; SE: 0.009; P-value: 0.011) using linear regression. We found no evidence of an association between tea intakes and sleep status, depression symptoms, anxiety and stress.

Conclusions: We found evidence of a significant association between tea intakes, sleep duration, and sleep quality at night. However, there was no significant association between tea intake and mental health. Future studies evaluating this relationship should consider different types of tea, as well as caffeine and other bioactive components.

Objectives: FreeStyle Libre (FSL) monitoring is available for all patients in Wales with insulin-treated diabetes. English guidance permits FSL in patients with type 1 diabetes mellitus (T1D) and type 2 diabetes mellitus (T2D) requiring multiple daily insulin doses (MDI) (National Institute for Health and Care Excellence 2023). The literature suggests benefits from using FSL, specifically improved glycaemic control and reduced hypoglycaemia.

Methods: Patients aged >18 years with insulin-treated T2D using FSL for ≥ 3 months were identified from Libreview. Those with pre- and post-FSL HbA1c were included. Days 1-14 of FSL data were taken as baseline. Patients were categorised by insulin regime (OD basal, premixed, basal bolus).

Results: 236 patients were identified and 189 patients included. The median follow-up duration was 14.6 [10.3-15.0] months. There were significant reductions in median HbA1c [8 mmol/mol, p < 0.001], time below range [< 4.0 mmol/L](1.2 ± 3.4 vs 0.6 ± 1.5%, p = 0.01), and low glucose average duration [52.1 ± 77.3 vs 35.6 ± 58.7 min, p = 0.01]. HbA1c improvements were greatest in OD basal [12 mmol/mol, p < 0.001] and pre-mixed [12.5 mmol/mol, p < 0.001] insulin regimes. Those taking premixed insulin had an increased time in target [7%, p < 0.05], reduced time above target [5.5%, p < 0.05] and reduced average glucose [0.3 mmol/L, p < 0.05] and GMI [2 mmol/mol, p < 0.01]. Patients on basal bolus insulin had significantly reduced time below range [0.5% p < 0.05].

Conclusions: Improvements in HbA1c were greatest in those taking OD basal or premixed insulins. Reductions in hypoglycaemia are likely to positively impact quality of life. Further studies will elucidate whether these improvements are directly related to improved quality of glycaemic data facilitating closer treatment titration, or behaviour changes related to FSL use.

Objectives: This study aimed to determine the rate of anti-osteoporotic treatment (AOT) within one year in patients presenting to the emergency department with fragility fractures and to investigate the effects of physiatrist visit, secondary cause of osteoporosis, and previous fracture history on the rate of AOT.

Methods: This study included patients aged 50 years and older who presented to the emergency department between January 1, 2019, and June 1, 2023, with fragility fractures. Demographic characteristics of the patients, a history of fragility fractures, causes of secondary osteoporosis, and clinical features of AOT within one year were recorded using the hospital information system. The effects of physiatrist visit, secondary cause of osteoporosis and previous fracture history on the rate of AOT were examined by chi-square analysis.

Results: The study included a total of 357 patients, with a mean age of 73.5 + 10.1 (range: 51-100) years. The rate of patients receiving AOT was 8.4%. It was observed that 63.3% of the patients receiving AOT had a physiatrist visit, and 70% had secondary osteoporosis. Physiatrist visit and the presence of secondary osteoporosis cause affected the AOT rate statistically significantly (p = .000, p = .003, respectively), while the previous fracture history did not affect the treatment rate (p = .147).

Conclusions: Patients presenting to the emergency department with fragility fractures had a low rate of receiving AOT within one year. Physiatrist visits and finding a secondary cause of osteoporosis increase the detection rate of fragility fractures.

Background and objective: : Diabetic foot ulcer (DFU) is one of the main health challenges of diabetes complications worldwide. A wide range of factors may increase the risk of DFU. This study aimed to investigate the risk factors of DFU among diabetic patients.

Methods: This case-control study was conducted on 800 diabetic patients at the Tehran diabetes clinic of the Endocrinology and Metabolism Research Institute in Iran. The case group included 400 diabetic patients diagnosed with DFU, while the control group included 400 diabetic patients without DFU. Data were collected through medical records, validated questionnaires, and clinical examinations. The association between factors and the risk of DFU was analyzed using both crude and adjusted logistic regression models, adjusting for confounders based on a directed acyclic graphs.

Results: The final adjusted model demonstrated significant direct associations between the risk of DFU with a longer duration of diabetes, a history of previous DFU, peripheral neuropathy, retinopathy, high blood pressure, severe kidney function loss, and good foot self-care. However, there were significant inverse associations between DFU risk with female gender, higher education levels, being married, use of oral diabetes drugs, higher hemoglobin levels, and high physical activity.

Conclusions: The risk of DFU was significantly associated with the following factors: diabetes duration, previous DFU history, peripheral neuropathy, retinopathy, blood pressure, kidney function, foot self-care, gender, education levels, marital status, diabetes drugs, hemoglobin levels, and physical activity. Further studies, especially ones in multicenter cohorts with a special focus on novel risk factors, are warranted to expand on our findings.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01582-z.

Objective: Type 2 Diabetes Mellitus (T2DM) is a global health concern, with complications such as diabetic nephropathy (DN) affecting 16.6% of patients and contributing to end-stage renal failure. Emerging research suggests that gut microbial communities may influence DN progression, potentially through mechanisms involving the renin-angiotensin system (RAS). This study aimed to evaluate changes in specific microbial genera in individuals with T2DM, both with and without DN, and to explore their associations with renal function markers and RAS activation.

Methods: A total of 120 participants were categorized into three groups: healthy controls, T2DM without DN, and T2DM with DN. Microbial abundances of genera including Escherichia, Prevotella, Bifidobacterium, Lactobacillus, Roseburia, Bacteroides, Faecalibacterium, and Akkermansia were quantified using qPCR targeting the bacterial 16 S rRNA gene. Gene expression levels of RAS-associated markers (ACE, AGT1R, AT2R, and Ang II) and inflammation-related genes (TNF-α, TLR4) were analyzed in peripheral blood mononuclear cells via qPCR.

Results: The study identified significant alterations in microbial composition. Genera such as Faecalibacterium, Akkermansia, Roseburia (butyrate producers), and Bifidobacterium (a potential probiotic) were markedly reduced in T2DM and DN groups compared to controls. Increased mRNA expression of RAS-related genes, including ACE, AGT1R, and Ang II, was observed in these groups. We also foun correlations between altered microbial genera, RAS gene expression, and clinical markers of renal dysfunction.

Conclusion: The findings suggest that specific microbial genera may influence the pathogenesis of DN through RAS activation and inflammatory pathways. These insights highlight potential therapeutic targets for mitigating DN progression in T2DM patients.

Objectives: Thyroid cancer (TC) is commonly recognized as the most prevalent type of malignancy affecting the endocrine system. This study aimed to assess the incidence of TC and its trends in the Iranian population.

Methods: The incidence rate of TC in Iran was determined using data from the Iranian National Population-based Cancer Registry (INPCR). The INPCR registered all new cancer cases through various diagnostic methods, including pathology reports, clinical and paraclinical data, and death registry reports.

Results: From 2014 to 2018, a total of 27,530 cases of TC were recorded. Among these cases, 21,932 (79.7%) were female, and 5,598 (20.3%) were male. The age-standardized incidence rate (ASR) of TC was 6.17 (95% confidence interval [CI]: 6.09-6.25) per 100,000 person-years, showing an upward trend from 4.61 (95% CI: 4.45-4.77) per 100,000 population in 2014 to 8.17 (95% CI: 7.97-8.37) in 2018. The ASR of TC in women was nearly 3.7 times higher than that in men (9.79 vs. 2.59 per 100,000 person-years). The ASR of TC was highest in younger age groups among women (40-50 years) compared to men, who had higher rates in older age groups (65-75 years). Papillary thyroid carcinoma (PTC), including its follicular variant, was the predominant histological type of TC in the Iranian population, accounting for 82.19% (n = 22,627) of cases, followed by follicular thyroid carcinoma (FTC) (n = 859; 3.12%).

Conclusions: Our data suggest that thyroid cancer rate has increased in Iran though comprehending the underlying reasons for this phenomenon requires further research.

Objectives: The in vivo assay is a key step in the development of a new compound as a drug. In the present work, bis-4-aminocoumarin derivative 3,3'-(p-tolylmethylene)bis(4-amino-2H-chromen-2-one) (PTBAC) and bis-4-hydroxycoumarin derivative 3,3'-((4-((1-(2-chlorobenzyl)-1H-1,2,3-triazol-4-yl)methoxy)phenyl)methylene)bis(4-hydroxy-2H-chromen-2-one) (2CTMBHC) that showed high anti-α-glucosidase activity on the yeast form of this enzyme were selected for in vivo anti-hyperglycemic assay.

Methods: The in vivo anti-hyperglycemic effect of PTBAC and 2CTMBHC was assessed using oral starch tolerance test in streptozotocin-induced diabetic albino mouse model, and the results were compared with acarbose as a representative inhibitor of intestinal α-glucosidase enzyme. Toxicity of the selected compounds was also evaluated in vivo.

Results: The obtained results revealed that both selected compounds, PTBAC and 2CTMBHC, showed more anti-diabetic effects when compared with acarbose as a standard drug. In vivo anti-diabetic assays also demonstrated that bis-4-hydroxycoumarin derivative 2CTMBHC was more potent than bis-4-aminocoumarin derivative PTBAC. In vivo results were also confirmed by in vitro and in silico studies. Moreover, there was not any apparent signs of toxicity and mortality in in vivo toxicity assay.

Conclusions: In summary, in vivo anti-hyperglycemic effects of two synthetic compounds PTBAC and 2CTMBHC was confirmed in this study. Given that these compounds exhibited no evidences of toxicity and mortality in mice, therefore, they are good candidates for further investigations.

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