Journal of diabetes and its complications最新文献

英文中文

High fat-induced the upregulation of LOX-1 in RF/6A cells under high glucose condition

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-27 DOI: 10.1016/j.jdiacomp.2025.109019

Qin Li , Mingmei Zhang , Qianying Gao , Xueyi Chen

Objective

To investigate the effect of ox-LDL on the expression of lectin-like receptor of ox-LDL (LOX-1) and intercellular adhesion molecule-1 (ICAM-1) in RF/6A cells under high-glucose condition.

Methods

RF/6A cells were cultured in normal or high-glucose medium for two days. Furthermore, RF/6A cells were cultured in medium with high glucose and ox-LDL or normal medium with ox-LDL. The concentrations of ox-LDL were determined by initial screening based on migration and immunofluorescence. The expressions of LOX-1 and ICAM-1 were determined by western blot.

Results

The maximal effect of glucose on RF/6A cells was observed with the concentration of 25 mmol/l for 48 h. The LOX-1 expression was upregulated under high glucose condition than normal glucose (p < 0.05). There were significant LOX-1 overexpression and blocked ICAM-1 activation in RF/6A cells under high-glucose condition (p < 0.05). In the normal medium with ox-LDL groups, LOX-1 expression was both increased than in the normal medium group (p < 0.05). In the high glucose medium with ox-LDL groups, the expression levels of LOX-1 and ICAM-1 were increased than the high glucose medium group (p < 0.05).

Conclusion

A certain concentration of ox-LDL blocks high-glucose-induced retinal vascular endothelial injury by inhibiting the upregulation of ICAM-1 due to a high-glucose environment. Dyslipidemia may play an important role in the development of diabetic retinopathy, emphasizing the importance of active regulation of blood lipids in diabetic retinopathy therapy.

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引用次数: 0

SGLT-2 inhibitors on cardiac autonomic function in individuals with and without type 2 diabetes mellitus

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-27 DOI: 10.1016/j.jdiacomp.2025.109021

Hasan Fehmi Özel , Şüheda Alpay , Emre Asker , Elif Sıdal Gültekin , Hasan Kazdağlı

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have emerged as key therapeutic agents in managing type 2 diabetes mellitus (T2DM) and obesity, offering benefits that extend beyond glycemic control. This review examines the role of SGLT-2 inhibitors in modulating cardiac autonomic function, with a particular focus on heart rate variability (HRV) as a biomarker of autonomic balance. These agents improve metabolic profiles through enhanced glucosuria, natriuresis, and weight loss, while concurrently reducing blood pressure. Importantly, they also attenuate sympathetic nervous system overactivity and promote parasympathetic modulation, which may lower the risk of adverse cardiovascular events.

The underlying mechanisms include not only the metabolic effects but also anti-inflammatory and antioxidative actions, which together contribute to improved endothelial function and vascular health. Advanced HRV analyses, encompassing traditional time and frequency domain methods as well as nonlinear approaches, have proven valuable in detecting early autonomic dysfunction in high-risk populations. Some studies suggest that SGLT-2 inhibitors may be associated with improvements in HRV parameters, such as increased SDNN and RMSSD and a reduced LF/HF ratio. However, findings are inconsistent across studies, and further research is needed to determine the extent and mechanisms of these potential effects.

Although these findings are promising, further standardized, long-term studies are essential to clarify the mechanisms and optimal therapeutic strategies involving SGLT-2 inhibitors in the management of autonomic dysfunction. Future research should also explore the synergistic potential of combining SGLT-2 inhibitors with other cardiometabolic therapies to enhance cardiovascular outcomes in individuals with and without T2DM.

{"title":"SGLT-2 inhibitors on cardiac autonomic function in individuals with and without type 2 diabetes mellitus","authors":"Hasan Fehmi Özel , Şüheda Alpay , Emre Asker , Elif Sıdal Gültekin , Hasan Kazdağlı","doi":"10.1016/j.jdiacomp.2025.109021","DOIUrl":"10.1016/j.jdiacomp.2025.109021","url":null,"abstract":"<div><div>Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have emerged as key therapeutic agents in managing type 2 diabetes mellitus (T2DM) and obesity, offering benefits that extend beyond glycemic control. This review examines the role of SGLT-2 inhibitors in modulating cardiac autonomic function, with a particular focus on heart rate variability (HRV) as a biomarker of autonomic balance. These agents improve metabolic profiles through enhanced glucosuria, natriuresis, and weight loss, while concurrently reducing blood pressure. Importantly, they also attenuate sympathetic nervous system overactivity and promote parasympathetic modulation, which may lower the risk of adverse cardiovascular events.</div><div>The underlying mechanisms include not only the metabolic effects but also anti-inflammatory and antioxidative actions, which together contribute to improved endothelial function and vascular health. Advanced HRV analyses, encompassing traditional time and frequency domain methods as well as nonlinear approaches, have proven valuable in detecting early autonomic dysfunction in high-risk populations. Some studies suggest that SGLT-2 inhibitors may be associated with improvements in HRV parameters, such as increased SDNN and RMSSD and a reduced LF/HF ratio. However, findings are inconsistent across studies, and further research is needed to determine the extent and mechanisms of these potential effects.</div><div>Although these findings are promising, further standardized, long-term studies are essential to clarify the mechanisms and optimal therapeutic strategies involving SGLT-2 inhibitors in the management of autonomic dysfunction. Future research should also explore the synergistic potential of combining SGLT-2 inhibitors with other cardiometabolic therapies to enhance cardiovascular outcomes in individuals with and without T2DM.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 5","pages":"Article 109021"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725128","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}

引用次数: 0

Lipoprotein-associated phospholipase A2 and diabetic peripheral neuropathy.

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-26 DOI: 10.1016/j.jdiacomp.2025.109020

Georgia Anastasiou, Viviana Maggio, Manfredi Rizzo, Evangelos Liberopoulos

引用次数: 0

Cost effectiveness of topical wound oxygen therapy for chronic diabetic foot ulcers

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-24 DOI: 10.1016/j.jdiacomp.2025.109016

Marion Kerr , Daisy Wild , Michael Edmonds , Andrew J.M. Boulton

Aims

To estimate the cost effectiveness of Topical Wound Oxygen therapy (TWO2) for chronic diabetic foot ulcers.

Methods

A Markov model was created to estimate the cost effectiveness of TWO2 over 2 years. Clinical outcome probabilities were estimated from a recent multi-national randomised controlled trial. Diabetic footcare costs were estimated for the National Health Service in England, based on national cost collections, published literature and expert opinion. Model inputs were varied in sensitivity analyses.

Results

Base case results indicate that at a weekly TWO2 price of £650 for up to 12 weeks, total diabetic footcare costs over 2 years are £5038 lower for a patient treated with TWO2 than for standard care, and QALYs are 0.07 higher. Probabilistic sensitivity analysis estimates an 81 % likelihood that the treatment is cost effective at a willingness to pay threshold of £25,000 per QALY.

Conclusions

Base case results indicate that if the clinical outcomes in the RCT are replicated in routine care, TWO2 is a dominant treatment, with lower cost and improved outcomes relative to standard care. Sensitivity analysis shows a high probability that the treatment is cost effective at a willingness to pay threshold of £25,000 per QALY.

{"title":"Cost effectiveness of topical wound oxygen therapy for chronic diabetic foot ulcers","authors":"Marion Kerr , Daisy Wild , Michael Edmonds , Andrew J.M. Boulton","doi":"10.1016/j.jdiacomp.2025.109016","DOIUrl":"10.1016/j.jdiacomp.2025.109016","url":null,"abstract":"<div><h3>Aims</h3><div>To estimate the cost effectiveness of Topical Wound Oxygen therapy (TWO2) for chronic diabetic foot ulcers.</div></div><div><h3>Methods</h3><div>A Markov model was created to estimate the cost effectiveness of TWO2 over 2 years. Clinical outcome probabilities were estimated from a recent multi-national randomised controlled trial. Diabetic footcare costs were estimated for the National Health Service in England, based on national cost collections, published literature and expert opinion. Model inputs were varied in sensitivity analyses.</div></div><div><h3>Results</h3><div>Base case results indicate that at a weekly TWO2 price of £650 for up to 12 weeks, total diabetic footcare costs over 2 years are £5038 lower for a patient treated with TWO2 than for standard care, and QALYs are 0.07 higher. Probabilistic sensitivity analysis estimates an 81 % likelihood that the treatment is cost effective at a willingness to pay threshold of £25,000 per QALY.</div></div><div><h3>Conclusions</h3><div>Base case results indicate that if the clinical outcomes in the RCT are replicated in routine care, TWO2 is a dominant treatment, with lower cost and improved outcomes relative to standard care. Sensitivity analysis shows a high probability that the treatment is cost effective at a willingness to pay threshold of £25,000 per QALY.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 5","pages":"Article 109016"},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705267","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}

引用次数: 0

Diabetic neuropathy in adolescents and young adults: The need for early detection and improved understanding.

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-24 DOI: 10.1016/j.jdiacomp.2025.109018

Prashanth R J Vas, Viviana Maggio, Manfredi Rizzo, Nikolaos Papanas

引用次数: 0

Contents/Barcode

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-22 DOI: 10.1016/S1056-8727(25)00062-5

引用次数: 0

The NGAL as a prognostic biomarker of kidney injury in children and adolescents with type 1 diabetes mellitus: A systematic review and meta-analysis

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-22 DOI: 10.1016/j.jdiacomp.2025.109002

Nikolaos Gkiourtzis , Anastasia Stoimeni , Panagiota Michou , Konstantinos Cheirakis , Maria Moutafi , Aristeidis Christakopoulos , Agni Glava , Paraskevi Panagopoulou , Georgios Tsigaras , Assimina Galli-Tsinopoulou , Athanasios Christoforidis , Despoina Tramma

Aims

A major complication of type 1 diabetes is diabetic kidney disease (DKD). Albuminuria and impaired glomerular filtration rate are the main characteristics of DKD. Neutrophil gelatinase-associated lipocalin (NGAL) levels may rise even in the early stages of DKD, even in patients with normoalbuminuria. We present the first systematic review and meta-analysis examining the prognostic role of NGAL exclusively in pediatric patients with type 1 diabetes.

Methods

A search through major databases was carried out until September 24, 2024, investigating the prognostic role of NGAL in kidney injury in pediatric patients with type 1 diabetes. A p < 0.05 was considered statistically significant. A study quality assessment was conducted using the Newcastle-Ottawa Scale.

Results

The standardized mean difference in urinary NGAL (uNGAL) levels between the type 1 diabetes group and healthy controls was statistically significant (SMD = 0.63, 95%CI [0.36,0.90]). A moderate positive relationship between uNGAL and ACR was identified (r = 0.53, 95 % CI [0.31–0.70]). The uNGAL revealed a high overall diagnostic accuracy (AUC = 0.881).

Conclusions

Urinary NGAL appears to be a valuable biomarker for early detection and understanding of DKD in individuals with type 1 diabetes. Future clinical studies should prioritize assessing the accuracy of NGAL in identifying kidney injury in pediatric patients with type 1 diabetes and the association of NGAL with traditional biomarkers in groups with similar characteristics.

{"title":"The NGAL as a prognostic biomarker of kidney injury in children and adolescents with type 1 diabetes mellitus: A systematic review and meta-analysis","authors":"Nikolaos Gkiourtzis , Anastasia Stoimeni , Panagiota Michou , Konstantinos Cheirakis , Maria Moutafi , Aristeidis Christakopoulos , Agni Glava , Paraskevi Panagopoulou , Georgios Tsigaras , Assimina Galli-Tsinopoulou , Athanasios Christoforidis , Despoina Tramma","doi":"10.1016/j.jdiacomp.2025.109002","DOIUrl":"10.1016/j.jdiacomp.2025.109002","url":null,"abstract":"<div><h3>Aims</h3><div>A major complication of type 1 diabetes is diabetic kidney disease (DKD). Albuminuria and impaired glomerular filtration rate are the main characteristics of DKD. Neutrophil gelatinase-associated lipocalin (NGAL) levels may rise even in the early stages of DKD, even in patients with normoalbuminuria. We present the first systematic review and meta-analysis examining the prognostic role of NGAL exclusively in pediatric patients with type 1 diabetes.</div></div><div><h3>Methods</h3><div>A search through major databases was carried out until September 24, 2024, investigating the prognostic role of NGAL in kidney injury in pediatric patients with type 1 diabetes. A <em>p</em> < 0.05 was considered statistically significant. A study quality assessment was conducted using the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>The standardized mean difference in urinary NGAL (uNGAL) levels between the type 1 diabetes group and healthy controls was statistically significant (SMD = 0.63, 95%CI [0.36,0.90]). A moderate positive relationship between uNGAL and ACR was identified (<em>r</em> = 0.53, 95 % CI [0.31–0.70]). The uNGAL revealed a high overall diagnostic accuracy (AUC = 0.881).</div></div><div><h3>Conclusions</h3><div>Urinary NGAL appears to be a valuable biomarker for early detection and understanding of DKD in individuals with type 1 diabetes. Future clinical studies should prioritize assessing the accuracy of NGAL in identifying kidney injury in pediatric patients with type 1 diabetes and the association of NGAL with traditional biomarkers in groups with similar characteristics.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 5","pages":"Article 109002"},"PeriodicalIF":2.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714987","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}

引用次数: 0

Urogenital side effects in male subjects with type 2 diabetes treated with SGLT-2 inhibitors: A single centre, longitudinal observation 接受 SGLT-2 抑制剂治疗的男性 2 型糖尿病患者的泌尿生殖系统副作用：单中心纵向观察

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-22 DOI: 10.1016/j.jdiacomp.2025.109015

Alice Del Zoppo , Chiara Rovera , Giovanni Petralli , Diego Moriconi , Anna Solini

Objective

SGLT-2 inhibitors (SGLT-2i) provide good glycaemic control and weight loss, ensuring clinically relevant cardiorenal benefits in subjects with and without type 2 diabetes (T2D); however, their use is related to an enhanced risk of urogenital infections, mainly in female subjects. We performed a prospective observation to assess incidence of urogenital complications in male sex new users of gliflozins.

Subjects and methods

In the 2021–2023 years, solely based on clinical indication, we started such therapy in 272 male T2D subjects; follow up visits were performed after about 1 year.

Results

At follow up, 90 subjects had discontinued SGLT-2i; 36 of them (40 %) due to onset of urogenital symptoms. We observed 6 cases of phimosis. Subjects who discontinued the treatment due to these side effects had a higher BMI and a better eGFR at baseline and they were less frequently treated with DPP-IV inhibitors.

Conclusions

A proper evaluation of the patient's phenotype might be useful in identifying subjects less prone to develop side effects driving SGLT-2i discontinuation; the combined use of SGLT-2i and DPP-IV inhibitors appears to be associated to a better long-term compliance to therapy in men.

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引用次数: 0

The burden of depression among patients with type 2 diabetes: An umbrella review of systematic reviews

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-19 DOI: 10.1016/j.jdiacomp.2025.109004

Nora Wulandari , Aly Lamuri , Fenneke van Hasselt , Talitha Feenstra , Katja Taxis

Objective

Depression is common among patients with type 2 diabetes (T2D) which is a major global health concern. This umbrella review aims to explore differences in reported depression prevalence among people with type 2 diabetes and to identify the factors contributing to the variation.

Methods

A literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane. We included systematic reviews with or without a meta-analysis that investigated the prevalence of depression in adult patients (age 18 years or older) with T2D. Two independent reviewers screened titles and abstracts. The following data were extracted: study characteristics, depression assessment approach, and depression prevalence from systematic reviews and each primary study.

Findings

Of the 23 systematic reviews meeting inclusion criteria, comprising 649 unique primary studies, pooled depression prevalence ranged from 8.9 % to 61.6 %, with substantial heterogeneity (I² values ranged from 89.41 % to 99.96 %). Studies conducted in the African (0.11 [95%CI 0.04–0.17]), Eastern Mediterranean (0.19 [95%CI 0.15–0.24]) and South-East Asia (0.08 [95%CI 0.03–0.13]) reported higher prevalence compared to the Americas. Additionally, studies utilizing screenings other than the Hamilton Depression Rating Scale (HDRS) exhibited lower prevalence rates (between −22 % and −0.10 %).

Conclusion

The burden of depression was high among people with T2D. Substantial variation was found in the prevalence of depression among individuals with T2D, depending on the WHO region and the depression assessment approach.

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引用次数: 0

Changes to insulin pump settings throughout pregnancy for individuals using assisted hybrid closed-loop therapy versus sensor-augmented pump therapy

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications

Pub Date : 2025-03-10 DOI: 10.1016/j.jdiacomp.2025.109000

Jocelynn King , Elizabeth Buschur , Rachel Garcetti , Laura Pyle , Casey Sakamoto , Janet Snell-Bergeon , Emily Nease , Anna Bartholomew , Kathleen Dungan , Sarit Polsky

Aims

We compared changes in insulin pump settings and insulin distribution throughout pregnancy and early postpartum for participants with type 1 diabetes using sensor-augmented pump therapy (SAPT) or hybrid closed-loop (HCL) therapy without a pregnancy-specific glucose target.

Methods

In this investigator-initiated trial 23 participants were randomized at 14–18 weeks gestation to HCL therapy or SAPT until 4–6 weeks postpartum. We compared the changes to insulin pump settings and insulin delivery between groups using mixed-effects models.

Results

There were no significant differences in total daily insulin dose between HCL and SAPT groups from preconception through 4–6 weeks postpartum. However, the proportion of total insulin coming from bolus insulin was higher for the HCL group in month 9 (70.9 % HCL vs 57.9 % SAPT, p = 0.014). The HCL group had a lower total daily basal dose compared to SAPT in months 9 and 10 (p < 0.05 for both) and a higher total daily bolus dose at month 10 compared to the SAPT group (55.2 units/day vs 37.1 units/day, p = 0.025). The number of changes to pump settings did not differ between groups. Active insulin time was significantly shorter in the HCL group at almost all time points through month 9 of pregnancy and early postpartum. Carbohydrate-to-insulin ratios were stronger for breakfast (p = 0.020) and lunch (p = 0.005) over gestation in the HCL group.

Conclusion

More bolus insulin and less basal insulin were used by the HCL group compared to the SAPT group, at least in part due to pump settings that contribute to more bolus insulin delivery.

{"title":"Changes to insulin pump settings throughout pregnancy for individuals using assisted hybrid closed-loop therapy versus sensor-augmented pump therapy","authors":"Jocelynn King , Elizabeth Buschur , Rachel Garcetti , Laura Pyle , Casey Sakamoto , Janet Snell-Bergeon , Emily Nease , Anna Bartholomew , Kathleen Dungan , Sarit Polsky","doi":"10.1016/j.jdiacomp.2025.109000","DOIUrl":"10.1016/j.jdiacomp.2025.109000","url":null,"abstract":"<div><h3>Aims</h3><div>We compared changes in insulin pump settings and insulin distribution throughout pregnancy and early postpartum for participants with type 1 diabetes using sensor-augmented pump therapy (SAPT) or hybrid closed-loop (HCL) therapy without a pregnancy-specific glucose target.</div></div><div><h3>Methods</h3><div>In this investigator-initiated trial 23 participants were randomized at 14–18 weeks gestation to HCL therapy or SAPT until 4–6 weeks postpartum. We compared the changes to insulin pump settings and insulin delivery between groups using mixed-effects models.</div></div><div><h3>Results</h3><div>There were no significant differences in total daily insulin dose between HCL and SAPT groups from preconception through 4–6 weeks postpartum. However, the proportion of total insulin coming from bolus insulin was higher for the HCL group in month 9 (70.9 % HCL vs 57.9 % SAPT, p = 0.014). The HCL group had a lower total daily basal dose compared to SAPT in months 9 and 10 (p < 0.05 for both) and a higher total daily bolus dose at month 10 compared to the SAPT group (55.2 units/day vs 37.1 units/day, p = 0.025). The number of changes to pump settings did not differ between groups. Active insulin time was significantly shorter in the HCL group at almost all time points through month 9 of pregnancy and early postpartum. Carbohydrate-to-insulin ratios were stronger for breakfast (p = 0.020) and lunch (p = 0.005) over gestation in the HCL group.</div></div><div><h3>Conclusion</h3><div>More bolus insulin and less basal insulin were used by the HCL group compared to the SAPT group, at least in part due to pump settings that contribute to more bolus insulin delivery.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 4","pages":"Article 109000"},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600551","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}

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