Journal of Diabetes and Metabolic Disorders最新文献

Purpose: This study aims to evaluate the association between the insulin resistance as assessed by Triglyceride-Glucose (TyG) index and dementia and to determine whether this relationship varies by sex.

Methods: We assessed TyG index in older patients admitted to an Italian Memory Clinic with different cognitive status: 335 (71% females-F) participants with Alzheimer's disease (AD), 99 (61% F) with vascular dementia (VAD), 301 (67% F) with mixed dementia (MIXED: AD + VAD), 442 (57% F) with mild cognitive impairment (MCI), and 173 cognitively healthy controls (61% F).

Results: We found that only in females high TyG index was associated with a greater probability of receiving a diagnosis of MCI (odd ratio - O.R.: 1.91, 95% confidence interval - C.I.: 1.08-3.34), VAD (O.R.: 2.23; 95% C.I.: 1.10-4.51), and MIXED (O.R.: 1.92, 95% C.I.: 1.10-3.33), but not AD (O.R.: 1.07, 95% C.I.: 0.63-1.85). Notably, these associations remained significant in a multi-adjusted model, including age, smoking, total cholesterol and comorbidities.

Conclusions: Our findings suggest that insulin resistance may be a risk factor for dementia with a cerebrovascular component, but only in older females.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01744-z.

Metabolic dysfunction-associated steatotic liver disease (MASLD), the most common subtype of steatotic liver disease (SLD), affects approximately 38% of the global adult population and is strongly linked to obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). Projections estimate its prevalence may exceed 55% by 2040. Obesity plays a central role in the progression from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Excess adiposity contributes to hepatic fat accumulation, systemic inflammation, insulin resistance, and activation of hepatic stellate cells. key mechanisms in liver injury and fibrogenesis. Diagnosis traditionally relied on liver biopsy, but noninvasive techniques, along with serum-based indices, are now commonly used. MASLD is associated with an increased risk of cardiovascular disease, chronic kidney disease, and endocrine disorders, particularly in obese individuals. Management is centered on weight reduction, which can reverse steatosis, resolve MASH, and regress fibrosis depending on the degree of weight loss. Recent therapeutic advances include the approval of resmetirom, a thyroid hormone receptor-β agonist, and promising results from glucagon-like peptide 1 (GLP-1) receptor agonists. Bariatric surgery offers significant benefits in selected patients, improving liver histology and associated metabolic parameters. Despite these developments, no universally accepted pharmacotherapy exists for MASLD. Future directions include expanding access to diagnostic tools, validating novel biomarkers, and implementing public health strategies targeting obesity to prevent progression to end-stage liver disease.

Purpose: Octreotide is second-line treatment for patients with congenital hyperinsulinism (CHI) unresponsive to diazoxide. Short-acting octreotide is administered via subcutaneous (SC) injection or continuous infusion using a pump, but limited data exist on pump therapy. We present two cases of CHI managed with an octreotide infusion via pump with or without concurrent continuous glucose monitoring (CGM), providing practical guidance.

Case presentation: Octreotide 500mcg/1ml ampoule was used. The starting dose was 5mcg/kg/day, with titration to optimize glycaemia, and delivered as a continuous basal rate using a pump. CGM was used by Patient 2.Patient 1: CHI due to a paternal ABCC8 mutation was detected at 16 weeks of age, with diffuse uptake on 18F-DOPA PET. Unresponsive to diazoxide, SC octreotide injections commenced, transitioning to an infusion (13mcg/kg/day) with good response, and complete cessation of therapy at four years.Patient 2: Neonate with CHI due to Beckwith Wiedemann Syndrome developed side-effects from diazoxide and was commenced on SC octreotide injections. Effective at 30mcg/kg/day, he transitioned to an infusion at 4.5 months followed by long-acting octreotide at 12 months.Both patients tolerated the infusion with no adverse effects.

Conclusion: This report highlights the practical use of octreotide infusion via pump. When combined with CGM, it allows for tailored dosing to meet individual needs while enhancing patient convenience.

Objective: To examine whether pre-pandemic diabetes is associated with an increased risk of Long COVID in a nationally representative UK cohort.

Methods: We conducted a prospective cohort analysis using data from the UK Household Longitudinal Study. A total of 11,669 adults aged ≥ 16 years were followed from Wave 10 (2018-19) to Wave 14 (2022-23). The primary exposure, pre-pandemic diabetes, was defined at baseline (Wave 10) based on self-report of a doctor diagnosis. The primary outcome, Long COVID, was assessed at follow-up (Wave 14) and defined as self-reported symptoms lasting more than 12 weeks after a COVID-19 infection that could not be explained by another cause. Modified Poisson regression models with robust standard errors were used to estimate relative risks of Long COVID associated with pre-pandemic diabetes. Predictive margins were then calculated to obtain adjusted probabilities.

Results: At follow-up, 1,076 participants (9.2%) reported Long COVID. In the unadjusted model, participants with pre-pandemic diabetes had a 36% higher risk of Long COVID compared with those without diabetes (RR = 1.36, 95% CI: 1.09-1.69, p = 0.006). After adjusting for age and sex, the relative risk increased to 1.43 (95% CI: 1.15-1.79, p = 0.002). In the fully adjusted model, which controlled for age, sex, ethnicity, education, income satisfaction, smoking, and other long-standing illness, the relative risk of Long COVID in participants with diabetes was 1.60 (95% CI: 1.27-2.02, p < 0.001). The adjusted predicted probability of long COVID was 14.4% (95% CI: 11.2-17.6) among those with diabetes, compared with 9.0% (95% CI: 8.5-9.5) among those without.

Conclusions: In this nationally representative prospective cohort, pre-pandemic diabetes emerged as an independent risk factor for Long COVID. Enhanced surveillance and targeted support for individuals with diabetes may be warranted in Long COVID care strategies.

Objectives: This review assessed the selected information on semaglutide's activity, its potential for the treatment of various diseases, and its pharmacokinetics. It is intended as a guide for future research. Chromatographic procedures used for the determination of semaglutide in various biological samples were also reviewed.

Methods: A comprehensive review of the literature was conducted by searching scientific databases including PubMed, Scopus, Web of Science, and Google Scholar. The search was performed using keywords such as diabetic, type of diabetics, impact of diabetic glucagon-like peptide, DPP-4 inhibitors, GLP-1 agonists, semaglutide and weight loss, semaglutide and obesity, semaglutide and diabetic retinopathy, semalutide and mood, semaglutide and mood disorder, semaglutide and fertility, semaglutide and thyroid, semaglutide and inflammation, semaglutide and cardiovascular system, semaglutide and imapct on heart, semaglutide and neuroprotection, semaglutide and pancreatitis, safety of semaglutide, semaglutide and side effects, semaglutide and contraindication, and semaglutide analysis by liquid chromatography.

Results: Semaglutide is the most potent glucose-lowering glucagon-like peptide (GLP-1) analogue and is widely used in the treatment of type 2 diabetes. Semaglutide increases the secretion of insulin from pancreatic β-cells and supresses glucagon release from pancreatic α-cells. Due to its effects on appetite regulation, it is also used to treat obesity in many countries. However, due to the slimming properties of the drug, semaglutide is often abused by non-diabetics, non-obese individuals, and young people. Recently, numerous investigations have been conducted to better understand the mechanism of action, as well as the advantages and disadvantages of using semaglutide. It is also very important to develop sensitive and accurate methods for detecting this drug in various biological samples collected from patients.

Conclusion: Semaglutide is increasingly used of for the treatment of type 2 diabetes; however, its misuse for weight loss is also increasing. Further research is required to confirm the benefits of using semaglutide and to optimize treatment strategies for diverse patient populations.

Purpose of review: The purpose of the study was to collect and summarise information available in the scientific literature on the probable reasons that lead to negative outcomes of COVID-19 in patients with pre-existing obesity and /or type 2 diabetes mellitus and influence on their treatment as also mortality.

Recent findings: During the COVID-19 pandemic, it was observed that disease severity is often correlated with existing comorbidities, mainly in older obese male patients. SARS-CoV-2-infected patients with chronic diseases required hospitalisation more often and their overall prognosis is worse. The following review describes the impact of obesity and diabetes on the SARS-CoV-2 infection course and mortality risk.

Summary: Diabetes and obesity have a multifactorial impact on the risk of SARS-CoV-2 virus infection, as well as on the nature and dynamics of the development of the infection. In turn, the presence of these diseases significantly increased the risk of requiring intensified treatment, complications and ultimately death. Limited access to medical care systems due to the pandemic and the impact on everyday activities made it even more difficult to control diabetes and obesity, leading to the deterioration of patient's condition and the occurrence of new cases of disease. Therefore, it is necessary not only to appropriately modify treatment of those already infected, but also to use appropriate prevention to reduce the number of potential high-risk patients.

Background: Diabesotension, an overlapping triad of diabetes, hypertension, and obesity, remains a diagnostic challenge due to its complex underlying molecular mechanisms. Individuals with diabesotension face twice the risk of microvascular and macrovascular complications compared to those with either condition alone. However, the complexity of diabesotension poses significant diagnostic challenges due to limited knowledge of this disease trifecta.

Methods: The protein network was constructed, and the DPClusOST algorithm was applied to determine the protein clusters with a density ranging from 0.1 to 1.0 and those relevant to the pathophysiology of diabesotension. The significance score (SScore) was computed using the p-value from Fisher's exact test to evaluate each cluster, and the clusters containing proteins associated with diabesotension were classified using receiver operating characteristic (ROC) analysis. The significant density of the cluster, as indicated by the AUC, was determined and subsequently subjected to pathway enrichment analysis using ShinyGO.

Results: At densities of 0.6 and 0.8, 14 proteins (STX3, VAMP2, STX4, SYT1, DNAJC5, HSD17B10, DLD, AIFM1, PDHA1, PDHB, DLAT, PDHX, OGDH, and STAT5A) from clusters 13 and 53 were significantly identified as potential diabesotension-related proteins. Key pathways associated with the tripartite interplay of the three pathologies were found to involve amino acid metabolism, glycolysis/gluconeogenesis, SNARE-mediated vesicle transport, insulin and salivary secretion, and the glucagon and HIF-1 signaling pathways, thus identifying novel candidates for diabesotension biomarkers and therapeutic targets.

Conclusions: This study highlights the use of graph clustering to identify potential biomarkers for the comorbid triad, which could enhance personalized future treatment strategies.

Objectives: Excessive salt intake is a global health concern, particularly for individuals with hypertension (HTN). Limited research has examined the relationship between salt consumption and blood pressure control in Iranians. This study aimed to evaluate daily salt intake among hypertensive Iranians and its association with blood pressure management.

Methods: Data were obtained from Iran's 2021 STEPS survey. Sample hypertensive patients were defined by self-report, antihypertensive medication use, or blood pressure (BP) measurements (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). Daily salt intake was estimated using the Tanaka method based on spot urine sodium levels and categorized based on calculated quartiles. BP was analyzed in both continuous and binary forms (controlled/uncontrolled). Logistic regression was applied to assess relationship between daily salt intake and uncontrolled hypertension as outcome.

Results: The final analysis included 6,795 participants who were divided into four quartiles according to their daily salt intake. With a mean daily salt intake of 10.1 g [95% Confidence Interval (CI): 9.9-10.3], participants with undiagnosed hypertension consumed the most salt, (10.1 g [95% CI: 9.9-10.3], p = 0.002). With odds ratios (ORs) of 1.42 [95% CI: 1.16-1.74] (p = 0.001) and 1.32 [95% CI: 1.07-1.63] (p = 0.008), respectively, the third and fourth quartiles in the crude model showed noticeably higher odds of uncontrolled hypertension than the lowest quartile. Following the full adjustment model, the odds of uncontrolled hypertension were not significantly different in the fourth quartile compared to the first quartile (OR = 1.10 [95% CI: 0.87-1.39]; p = 0.404).

Conclusions: Since increased salt intake raises SBP and DBP, particularly in those who are unaware of their condition, this study emphasizes the urgent need for public health interventions, such as nutritional counselling for low-salt diet, to reduce salt intake, especially in the Iranian population suffering from hypertension.

Background: Diabetes mellitus is a serious, chronic metabolic disorder associated with microvascular and macrovascular complications that affect the cardiac, renal, ophthalmic, cerebral, and peripheral systems. Similar complications can also occur in the structures of the inner ear.

Objectives: This study aimed to assess the hearing function of patients diagnosed with T2DM and to investigate the relationship between hearing function and the stage of diabetic retinopathy.

Methods: This prospective, single-center, cross-sectional, and case-control study included 30 healthy controls (Group 1) and 90 patients with T2DM [30 without retinopathy (Group 2), 30 with non-proliferative diabetic retinopathy (Group 3), and 30 with proliferative diabetic retinopathy (Group 4)] aged 40 to 60 years. The best-corrected visual acuity and audiological tests, including pure tone audiometry (PTA) and high frequency audiometry (HFA), were performed.

Results: A statistically significant difference was observed at all frequencies (for all, p < 0.001), except for 125 Hz (for 125 Hz, p = 0.075). The median PTA values were 13.75 (min-max: 5-31.2) in Group 1, 20 (min-max: 10-37.5) in Group 2, 16.87 (min-max: 8.7-42.5) in Group 3, and 24.37 (min-max: 12.5-56.25) in Group 4. A multiple comparisons analysis for PTA showed a statistically significant difference between Group 1 and Group 4 (p < 0.001). The mean HFA values were 32.23 ± 12.27 in Group 1, 50.23 ± 12.80 in Group 2, 53.47 ± 10.75 in Group 3, and 62.63 ± 12.52 in Group 4. The HFA values were significantly lower in Group 1 compared to the other groups (p < 0.001). In pairwise comparisons, p = 0.730 for Group 2 vs. Group 3, p = 0.001 for Group 2 vs. Group 4, and p = 0.021 for Group 3 vs. Group 4.

Conclusions: It was observed that T2DM patients were at risk for developing hearing impairment, and sensorineural hearing impairment increased as the DR stage progressed, particularly in high frequencies. These results suggest a hearing evaluation in the screening of DR patients.

Objective: This study was conducted in order to evaluate the effect of insulin administration training provided to patients with Type 2 diabetes mellitus who use insulin on their safe medication usage, pain levels, and treatment perception.

Methodology: A randomized controlled trial was designed. This study was conducted with a total of 84 patients (43 in the experimental group and 41 in the control group) diagnosed with Type 2 diabetes who were admitted to a public hospital in the Southeastern Anatolia Region of Turkey between October 2022 and March 2023. The patient information form, Insulin Administration Skill Observation Form, Visual Analog Scale, and Insulin Treatment Appraisal Scale were used. The experimental group was provided with individualized training and a booklet on the use of insulin.

Results: Both posttest and retention test measurements were taken after the insulin administration training. According to these measurements, insulin administration skill and insulin treatment perceptions of the experimental group were significantly higher than those of the control group, while their pain intensity score was significantly lower (p < 0.001).

Conclusion: The results of this study revealed that the insulin administration training increased safe medication application and insulin treatment perceptions of the patients in the experimental group and lowered their pain levels.

Trial registration: ClinicalTrials.gov = NCT05915338.