Journal of Diabetes and Metabolic Disorders最新文献

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.

Purpose: Type 2 diabetes is a common metabolic disorder characterized by hyperglycemia and insulin resistance. The metabolism of amino acids is also affected in diabetes, particularly through gluconeogenesis and increased catabolism of branched-chain amino acids. The aminoacylase 1 (ACY-1) enzyme plays a crucial role in the hydrolysis of N-acetylated amino acids, leading to the release of free amino acids. In this study, we aimed to investigate the circulating level of ACY-1 in individuals with type 2 diabetes mellitus (T2DM) and its correlation with glycemic factors.

Methods: A total of 30 subjects with T2DM, 30 pre-diabetic individuals, and 30 control subjects were enrolled in the current study. Serum levels of ACY-1 and insulin were measured using ELISA method. Fasting Blood Sugar (FBS), 2-hour Postprandial (2hPP) glucose, HbA1c, urea, and creatinine levels were measured using an auto-analyzer. Insulin resistance was calculated using HOMA-IR formula.

Results: We found elevated levels of serum ACY-1 in individuals with diabetes compared to those with pre-diabetes (P = 0.04) and the control group (P < 0.0001). Additionally, the pre-diabetes group exhibited significantly higher levels of ACY-1 than control group (P = 0.0093). Furthermore, a correlation was observed between ACY-1 and glycemic parameters, including insulin (R=-0.263, P = 0.014), FBS (R = 0.453, P = 0.00001), and HbA1c (R = 0.382, P = 0.016), which may have clinical significance.

Conclusion: Patients with T2DM and individuals with pre-diabetes exhibit elevated serum levels of the aminoacylase-1 enzyme, which correlate with hyperglycemic factors such as FBS, HbA1c, and insulin. This finding underscores the significance of ACY-1 in the pathogenesis and progression of type 2 diabetes.

Objective: Diabetes is a widespread metabolic and chronic disease worldwide. Similar to other chronic diseases, psychological factors may play a role in the course of this disease. In this study, an attempt was made to examine the relationship between depression, anxiety and health literacy with the severity of diabetes and the mediating role of fear of disease progression.

Methods: A total of 225 patients with diabetes who visited the specialized and sub-specialized diabetes clinic in Amol city were selected through the they were selected using a convenient sampling method and a systematic approach based on inclusion criteria, and answered the 9-item Patient Health Questionnaire, Beck Anxiety Inventory, short form of Fear of Disease Progression and Health Literacy Inventory. To measure the severity of diabetes, HbA1c levels from the last blood test were measured. Structural equation modeling was used to test a hypothesized model. According to the fit indices, CMIN/df = 3.34, Goodness-of-fit index = 0.90, Normed Fit Index = 0.91, Comparative Fit Index = 0.90, and Root Mean Square Error of Approximation = 0.08 indicated an acceptable fit of the research model. The data were analyzed using SPSS version 26 and LISREL version 8/80 software.

Results: The findings showed significantly positive relationships between anxiety (β = 0.29, r = 0.552), depression (β‌ = 0.13, r = 0.485), fear of disease progression (β = 0.14, r = 0.486) and the severity of diabetes. Also, a significantly negative relationship was observed between health literacy and severity of diabetes (β = -0.4, r = -0.564). In addition, it was shown that in diabetic patients, the fear of disease progression plays a mediating role in the relationship between depression (B = 0.03, T-value = 2.12), anxiety (B = 0.03, T-value = 2.42) and health literacy (B = -0.03, T-value = -2.69) with the disease severity.

Conclusion: Therapeutic interventions to reduce the level of anxiety, depression and fear of disease progression and improve the level of health literacy of patients with diabetes can help in reducing the severity of diabetes. The generalizability of the results to other population requires confirmation by further research.

Type 2 diabetes (T2D) is a major health issue characterized by glucose intolerance and insulin resistance, resulting in elevated blood glucose levels and insufficient insulin production by the pancreatic β-cells. This dysfunction triggers a chronic inflammatory immune response. Given the documented benefits of medicinal plants in managing diabetic complications and the therapeutic potential of Periploca laevigata Aiton (PL) extracts, this study evaluated their antidiabetic and anti-inflammatory properties using the pancreatic β-cell line INS-1E under hyperglycemic conditions. Root, fruit, and Leaf extracts of PL were prepared, phytochemically characterized, and assessed for anti-inflammatory effects via RT-qPCR in glucose-treated INS-1E cells. A non-cytotoxic concentration (0.125 mg/mL) was selected for all assays. Phytochemical screening revealed the presence of tannins and flavonoids, compounds associated with antidiabetic and anti-inflammatory activity. Notably, PL extracts upregulated insulin gene expression, with Leaf extracts exhibiting the most pronounced effects: they significantly enhanced GLUT-2 and PDX-1 gene expression in glucose-treated INS-1E cells. Additionally, PL extracts downregulated iNOS while upregulating IL-10 gene expression. A trend toward reduced NF-κB and MCP-1 gene expression was also observed. Collectively, these results suggest that PL extracts could improve pancreatic β-cell function and mitigate inflammation, highlighting their potential as adjunct therapy for T2D.

Purpose: This study investigated the cardioprotective effects of an eight-week aerobic exercise program on cardiac histological and stereological parameters in rats with type 2 diabetes mellitus (T2DM), with a focus on structural remodeling and tissue composition.

Methods: Thirty-two male Wistar rats were randomly assigned to four groups: diabetic exercise (Dia + Exe), healthy exercise (Heal + Exe), diabetic control (Dia + Con), and healthy control (Heal + Con) groups. T2DM was induced via a high-fat diet combined with a low-dose streptozotocin injection. The aerobic exercise protocol involved progressive treadmill training five days per week for eight weeks. Stereological analysis, which is based on systematic uniform random sampling, was conducted to assess cardiac dimensions, tissue composition, and myocyte morphology. Histological evaluation was performed via hematoxylin and eosin (H&E) staining.

Results: Eight weeks of aerobic exercise significantly mitigated diabetes-induced cardiac atrophy, increasing the absolute heart weight by 48.9% (0.911 ± 0.048 g vs. 0.612 ± 0.057 g, p < 0.001) and normalizing the relative heart weight. Exercise led to a 41.4% increase in total cardiac volume, a 103% increase in cardiac muscle volume, and improvements in myocyte dimensions in diabetic rats. Additionally, exercise reduced pathological remodeling by decreasing connective tissue volume (7.1% reduction) and restoring vascular bed architecture (22.4% reduction), with significant exercise × diabetes interactions (p < 0.01).

Conclusion: This study provides robust stereological evidence that aerobic exercise protects against diabetic cardiomyopathy by reversing cardiac atrophy, increasing muscle volume, reducing pathological fibrosis, and normalizing vascular architecture. These findings highlight aerobic exercise as a promising nonpharmacological intervention for preventing diabetes-induced cardiac structural deterioration.

Purpose: A great number of individuals with type 2 diabetes mellitus (T2DM) suffer from sleep disturbances and chronic fatigue. Despite the potential role of diet in improving these problems, the relation between dietary micronutrients and these complications among individuals with T2DM has been less studied. This study aimed to investigate the associations between dietary micronutrient adequacy index (DMAI) and sleep quality, sleep duration, and chronic fatigue among patients with T2DM.

Methods: In this cross-sectional study, 260 patients with T2DM aged 30-60y were enrolled. Sleep status and chronic fatigue were assessed using the Pittsburgh Sleep Quality Index and Chalder Fatigue Scale, respectively. Dietary intakes were collected through a validated food frequency questionnaire. DMAI was computed based on 14 micronutrients, with higher scores indicating greater adequacy. Binary logistic regression was employed to examine the relation between DMAI and study outcomes.

Results: The mean age of participants was 50.42 ± 6.11 years. After adjusting all confounders, participants with the highest DMAI had significantly lower odds of poor sleep quality (OR = 0.32; 95% CI: 0.13, 0.79) and short sleep duration (OR = 0.16; 95% CI: 0.06, 0.44) compared to those with the lowest. However, DMAI was not significantly related to chronic fatigue in the fully adjusted model (OR _{T3 vs. T1} = 0.31; 95% CI: 0.09, 1.04).

Conclusions: This study suggests that higher DMAI, indicating higher intakes of micronutrients, was associated with a reduced likelihood of poor sleep quality and short sleep duration, but not chronic fatigue among patients with T2DM. Prospective studies are recommended to replicate these findings.

Objectives: Trimethylamine N-oxide (TMAO) is related to the pathogenesis of Metabolic dysfunction-associated fatty liver disease (NAFLD). However, the molecular mechanism of how TMAO causes MAFLD development is still unclear. The present study attempted to investigate whether TMAO contributes to MAFLD development through HULC in a cellular model of MAFLD.

Methods: HepG2 cells were cultured and induced in a fatty liver cell model. HULC knockdown was induced using the CRISPR/Cas13 system. Fatty liver cells were exposed to TMAO concentrations (75µM and 300µM) before and after HULC knockdown. RT-qPCR was used to evaluate the expression of the target genes. Apoptosis was assessed using Annexin V-FITC and PI staining. Statistical analyses included ANOVA and post-hoc tests.

Results: TMAO upregulated the expression of HULC, followed by P38MAPK overexpression (P value < 0.05). Upon HULC knockdown, TMAO could not change P3MAPK expression and its downstream targets, including TNFα, IL-6, and PNPPLA3 in fatty liver cells. Additionally, TMAO significantly induced apoptosis in the fatty acid cellular model (P value < 0.05).

Conclusion: In conclusion, the results of this study provide evidence of the TMAO/HULC/P38MAPK axis involvement in the pathogenesis of MAFLD by increasing the expression of genes involved in inflammation and fibrosis. Our data suggests that TMAO reduction could be a therapeutic target in MAFLD through gut microbiome modulation.

Purpose: Several factors are attributed to the development of gestational diabetes mellitus (GDM), but its association with the ABO blood group is still unexplored. Hence, we performed a meta-analysis to examine this association.

Methods: Relevant articles were obtained from various databases until April 5, 2025. All related data were extracted by two authors and summarized in a customized spreadsheet. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed and interpreted.

Results: The pooled analysis showed homogeneity in the outcomes. Pooled ORs show that pregnant women with non-blood type O showed more significant associations than those with blood type O.

Conclusion: Overall, the present meta-analysis suggests that individuals with non-blood type O have an increased risk of developing GDM compared to those with blood type O. However, further studies stratifying populations based on insulin resistance, gut microbiota, and inflammation in association with ABO and GDM development are needed to confirm these claims.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01653-1.

Millions of people worldwide have diabetes, a disease that is becoming more common and has substantial socioeconomic costs. Artificial intelligence (AI) improves diabetes management, diagnosis, and prevention. AI-powered tools enable early detection of diabetes and its complications, including diabetic retinopathy, using sophisticated algorithms and large-scale data analysis. Wearable devices and continuous glucose monitors, integrated with AI, facilitate personalized treatment plans and real-time insights, improving glycemic control and overall health outcomes. Advanced machine learning models demonstrate high accuracy in diagnosing and predicting diabetes, while automated insulin delivery systems and bolus calculators enhance insulin management, reducing risks of hypo- and hyperglycemia. Despite these advancements, challenges such as cost, accessibility, device interoperability, and ethical considerations persist. The development of new digital biomarkers, individualized clinical metrics, and patient-centric solutions is critical for optimizing care. While AI holds immense promise in alleviating the global diabetes burden, addressing these limitations through sustained innovation and collaboration is essential. This review underscores the transformative potential of AI in revolutionizing diabetes care, enabling advancement for enhanced prevention, precise diagnosis, and effective management strategies.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01648-y.

Background: Automated insulin delivery has been developed with various algorithms and designs. Omnipod 5 is the latest Commercially available device. We aimed to explore the safety efficacy and psychological impact of the new Omnipod hybrid closed-loop system.

Methods: We used PubMed, Google Scholar, Scopus, Web of Science, and Cochrane Library for our search, we analyzed pre and post-data for continuous glucose monitoring data and HbA1C using RevMan software. When we observed heterogeneity, we used random effect model otherwise fixed effect model was used. We addressed heterogeneity using leave-one-out sensitivity analysis. We performed subgroup analysis based on study design and age subgroups. We reported outcomes that couldn't be analyzed narratively.

Results: Out of 12 studies with 13 reports, we analyzed pre and post-data of eight studies. Pooled data of 665 patients showed significant improvement in time in range 70-180mg/dl [MD 11.30% [95% CI: 9.75 to 12.84], P < 0.00001]. Time above range 180mg/dl was significantly improved [MD -9.88% [95% CI: -11.52 to -8.25], P < 0.00001]. Among six trials nighttime time below range 70mg/dl showed significant results TBR [MD -2.6% [95%CI: -3.77 to -1.44], p < 0.0001] with Considerable heterogeneity that was fixed by sensitivity analysis. Omnpod hybrid closed loop [HCL] showed improvement in type 1 diabetes distress score which is consistent among reported studies.

Conclusion: Post Omnipod HCL usage showed improvement in 24h and nighttime which needs confirmation with more evidence.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01639-z.