Pub Date : 2024-04-26DOI: 10.1016/S1056-8727(24)00077-1
{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(24)00077-1","DOIUrl":"https://doi.org/10.1016/S1056-8727(24)00077-1","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724000771/pdfft?md5=ee3a4f00ea98b867a2267c760605d0a8&pid=1-s2.0-S1056872724000771-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650677","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}
Pub Date : 2024-04-25DOI: 10.1016/j.jdiacomp.2024.108761
Hatice Isik Mizrak , Huda Kufaishi , Sofie Korsgaard Hecquet , Tine Willum Hansen , Rodica Pop-Busui , Peter Rossing , Birgitte Brock , Christian Stevns Hansen
Background
Population-based prevalence estimates of distal symmetric polyneuropathy (DPN) and diabetic autonomic neuropathy (DAN) are scares. Here we present neuropathy estimates and describe their overlap in a large cohort of people with type 1 and type 2 diabetes.
Methods
In a large population of outpatient participants, DPN was assessed using vibration perception threshold, sural nerve function, touch, pain and thermal sensation. Definite DPN was defined by the Toronto Consensus Criteria. Painful DPN was defined by Douleur Neuropathique 4 Questions. DAN measures were: cardiovascular reflex tests, electrochemical skin conductance, and gastroparesis cardinal symptom index.
Results
We included 822 individuals with type 1 (mean age (±SD) 54 ± 16 years, median [IQR] diabetes duration 26 [15–40] years) and 899 with type 2 diabetes (mean age 67 ± 11 years, median diabetes duration 16 [11−22] years).
Definite DPN was prevalent in 54 % and 68 %, and painful DPN was in 5 % and 15 % of type 1 and type 2 participants, respectively. The prevalence of DAN varied between 6 and 39 % for type 1 and 9–49 % for type 2 diabetes. DPN without other neuropathy was present in 45 % with T1D and 50 % with T2D.
Conclusion
The prevalence of DPN and DAN was high. DPN and DAN co-existed in only 50 % of cases.
{"title":"Contemporary prevalence of diabetic neuropathies in individuals with type 1 and type 2 diabetes in a Danish tertiary outpatient clinic","authors":"Hatice Isik Mizrak , Huda Kufaishi , Sofie Korsgaard Hecquet , Tine Willum Hansen , Rodica Pop-Busui , Peter Rossing , Birgitte Brock , Christian Stevns Hansen","doi":"10.1016/j.jdiacomp.2024.108761","DOIUrl":"10.1016/j.jdiacomp.2024.108761","url":null,"abstract":"<div><h3>Background</h3><p>Population-based prevalence estimates of distal symmetric polyneuropathy (DPN) and diabetic autonomic neuropathy (DAN) are scares. Here we present neuropathy estimates and describe their overlap in a large cohort of people with type 1 and type 2 diabetes.</p></div><div><h3>Methods</h3><p>In a large population of outpatient participants, DPN was assessed using vibration perception threshold, sural nerve function, touch, pain and thermal sensation. Definite DPN was defined by the Toronto Consensus Criteria. Painful DPN was defined by Douleur Neuropathique 4 Questions. DAN measures were: cardiovascular reflex tests, electrochemical skin conductance, and gastroparesis cardinal symptom index.</p></div><div><h3>Results</h3><p>We included 822 individuals with type 1 (mean age (±SD) 54 ± 16 years, median [IQR] diabetes duration 26 [15–40] years) and 899 with type 2 diabetes (mean age 67 ± 11 years, median diabetes duration 16 [11−22] years).</p><p>Definite DPN was prevalent in 54 % and 68 %, and painful DPN was in 5 % and 15 % of type 1 and type 2 participants, respectively. The prevalence of DAN varied between 6 and 39 % for type 1 and 9–49 % for type 2 diabetes. DPN without other neuropathy was present in 45 % with T1D and 50 % with T2D.</p></div><div><h3>Conclusion</h3><p>The prevalence of DPN and DAN was high. DPN and DAN co-existed in only 50 % of cases.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774181","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}
Pub Date : 2024-04-20DOI: 10.1016/j.jdiacomp.2024.108747
Laurence D. Petty , Enrique Soto-Pedre , Rory J. McCrimmon , Ewan R. Pearson
Information on BMI and risk of developing hypertension in type 1 diabetes (T1D) is scarce, and it comes mostly from cross-sectional analyses. This study underscores a risk of developing hypertension in T1D individuals with high BMI, and this risk appears to be higher than in those with type 2 diabetes.
{"title":"Body Mass Index's influence on arterial hypertension in Type 1 diabetes – A brief report from IMI-SOPHIA study","authors":"Laurence D. Petty , Enrique Soto-Pedre , Rory J. McCrimmon , Ewan R. Pearson","doi":"10.1016/j.jdiacomp.2024.108747","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108747","url":null,"abstract":"<div><p>Information on BMI and risk of developing hypertension in type 1 diabetes (T1D) is scarce, and it comes mostly from cross-sectional analyses. This study underscores a risk of developing hypertension in T1D individuals with high BMI, and this risk appears to be higher than in those with type 2 diabetes.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620642","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}
This study aimed to investigate the relationship between changes in glucose metabolism and body composition in patients with diabetes.
Methods
We included 380 patients with type 2 diabetes, who underwent bioelectrical impedance analysis, in this longitudinal study. Changes in HbA1c (ΔHbA1c) levels and body composition indices were compared between baseline and 6 months. A multivariate analysis was performed to examine the relationship between ΔHbA1c and changes in body composition.
Results
HbA1c levels were significantly decreased at 6 months (P < 0.01), but there was no significant change in BMI. A linear multiple regression analysis showed that ΔHbA1c was negatively correlated with changes in muscle mass (β = −0.18; P = 0.047) and bone mineral content (β = −0.28; P < 0.001), but there was no significant association between ΔHbA1c levels and a change in body fat percentage.
Conclusions
This study shows a limited association between short-term changes in glucose metabolism and changes in body composition in patients with type 2 diabetes. Therefore, interventions aimed at reducing adiposity may not affect glucose metabolism in the short term, while interventions focused on maintaining or enhancing muscle mass and bone mineral content may play an important role in diabetes management.
{"title":"Association of short-term changes in HbA1c with body composition and the importance of muscle maintenance in patients with Type 2 diabetes","authors":"Kazuhiro Nomura , Satoshi Inagaki , Naokazu Muramae , Hiroaki Takahashi , Kozue Abe , Kenji Kato , Yoshiaki Kido , Tomokazu Matsuda","doi":"10.1016/j.jdiacomp.2024.108746","DOIUrl":"10.1016/j.jdiacomp.2024.108746","url":null,"abstract":"<div><h3>Aims</h3><p>This study aimed to investigate the relationship between changes in glucose metabolism and body composition in patients with diabetes.</p></div><div><h3>Methods</h3><p>We included 380 patients with type 2 diabetes, who underwent bioelectrical impedance analysis, in this longitudinal study. Changes in HbA1c (ΔHbA1c) levels and body composition indices were compared between baseline and 6 months. A multivariate analysis was performed to examine the relationship between ΔHbA1c and changes in body composition.</p></div><div><h3>Results</h3><p>HbA1c levels were significantly decreased at 6 months (<em>P</em> < 0.01), but there was no significant change in BMI. A linear multiple regression analysis showed that ΔHbA1c was negatively correlated with changes in muscle mass (β = −0.18; <em>P</em> = 0.047) and bone mineral content (β = −0.28; <em>P</em> < 0.001), but there was no significant association between ΔHbA1c levels and a change in body fat percentage.</p></div><div><h3>Conclusions</h3><p>This study shows a limited association between short-term changes in glucose metabolism and changes in body composition in patients with type 2 diabetes. Therefore, interventions aimed at reducing adiposity may not affect glucose metabolism in the short term, while interventions focused on maintaining or enhancing muscle mass and bone mineral content may play an important role in diabetes management.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770156","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}
Pub Date : 2024-04-13DOI: 10.1016/j.jdiacomp.2024.108745
Huda Kufaishi , Hatice Isik Mizrak , Birgitte Brock , Tine Willum Hansen , Peter Rossing , Christian Stevns Hansen
Objective
We investigated associations between gastrointestinal symptoms - evaluated as a combined weighted symptom score (CWSS) – Diabetic autonomic neuropathy (DAN), and distal symmetrical polyneuropathy (DSPN) in type 1 and type 2 diabetes.
Research design and methods
Cross-sectional study in a tertiary outpatient clinic. CWSS was calculated based on questionnaires: gastroparesis composite symptom index (GCSI) and gastrointestinal symptom rating score (GSRS). DAN and DSPN were addressed using the composite autonomic symptom score 31 (COMPASS-31) questionnaire, cardiac autonomic reflex tests (CARTs), electrochemical skin conductance (ESC), vibration perception threshold (VPT), Michigan Neuropathy Screening Instrument (MNSI), pain- and thermal sensation.
Analyses were adjusted for age, sex, diabetes duration, smoking, LDL-cholesterol, HbA1C and systolic blood pressure. Type 1 and type 2 diabetes were evaluated separately.
Results
We included 566 with type 1 diabetes and 377 with type 2 diabetes. Mean ± SD age was 58 ± 15 years and 565 (59.9 %) were women. A high CWSS was present in 143 (25 %) with type 1 and 142 (38 %) with type 2 diabetes. The odds of DAN by COMPASS-31 (p<0.001) were higher in the high score group. For type 1 diabetes, odds of cardiac autonomic neuropathy were higher in the high CWSS group. The odds of DSPN by VPT and MNSI in type 1 diabetes, and by ESC, VPT and pain sensation in type 2 diabetes were higher in the high CWSS group.
Conclusions
A high symptom score was associated with neuropathy by COMPASS-31 and vibration perception. Gastrointestinal symptom burden associated inconsistently with other neuropathy tests between diabetes types.
{"title":"Gastrointestinal symptom burden in diabetic autonomic and peripheral neuropathy – A Danes cohort study","authors":"Huda Kufaishi , Hatice Isik Mizrak , Birgitte Brock , Tine Willum Hansen , Peter Rossing , Christian Stevns Hansen","doi":"10.1016/j.jdiacomp.2024.108745","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108745","url":null,"abstract":"<div><h3>Objective</h3><p>We investigated associations between gastrointestinal symptoms - evaluated as a combined weighted symptom score (CWSS) – Diabetic autonomic neuropathy (DAN), and distal symmetrical polyneuropathy (DSPN) in type 1 and type 2 diabetes.</p></div><div><h3>Research design and methods</h3><p>Cross-sectional study in a tertiary outpatient clinic. CWSS was calculated based on questionnaires: gastroparesis composite symptom index (GCSI) and gastrointestinal symptom rating score (GSRS). DAN and DSPN were addressed using the composite autonomic symptom score 31 (COMPASS-31) questionnaire, cardiac autonomic reflex tests (CARTs), electrochemical skin conductance (ESC), vibration perception threshold (VPT), Michigan Neuropathy Screening Instrument (MNSI), pain- and thermal sensation.</p><p>Analyses were adjusted for age, sex, diabetes duration, smoking, LDL-cholesterol, HbA<sub>1C</sub> and systolic blood pressure. Type 1 and type 2 diabetes were evaluated separately.</p></div><div><h3>Results</h3><p>We included 566 with type 1 diabetes and 377 with type 2 diabetes. Mean ± SD age was 58 ± 15 years and 565 (59.9 %) were women. A high CWSS was present in 143 (25 %) with type 1 and 142 (38 %) with type 2 diabetes. The odds of DAN by COMPASS-31 (<em>p</em> <em><</em> <em>0.001</em>) were higher in the high score group. For type 1 diabetes, odds of cardiac autonomic neuropathy were higher in the high CWSS group. The odds of DSPN by VPT and MNSI in type 1 diabetes, and by ESC, VPT and pain sensation in type 2 diabetes were higher in the high CWSS group.</p></div><div><h3>Conclusions</h3><p>A high symptom score was associated with neuropathy by COMPASS-31 and vibration perception. Gastrointestinal symptom burden associated inconsistently with other neuropathy tests between diabetes types.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550955","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}
Pub Date : 2024-04-05DOI: 10.1016/j.jdiacomp.2024.108744
Dongming Zhao , Jingming Ma , Yuman Sun , Wei Huang , Jinyang Fan , Mingzhe Ye , Bo Hu , Xinyi Sun
Introduction
The prevalence of diabetes mellitus is increasing year by year globally, and diabetic cardiomyopathy (DCM), as the most common complication of type 2 diabetes mellitus, seriously affects the prognosis of patients. Trimetazidine (TMZ), as a drug affecting myocardial energy metabolism, mainly reduces the oxidation rate of β-oxidation by inhibiting 3-ketoacyl-CoA thiolase (3-KAT), a key enzyme in β-oxidation of free fatty acid (FFA), so that the energy metabolism substrate of cardiomyocytes preferentially selects glucose rather than fatty acids, increases the content of intracellular adenosine triphosphate (ATP), enhances the contractile function of cardiomyocytes, and improves the state of cellular ischemia and hypoxia. Previous studies have shown that TMZ is closely related to the activation and induction of apoptosis of the MAPK pathway and AMPK pathway, and plays a role in the treatment of diabetic cardiomyopathy, but the specific mechanism is still unclear.
Objective
This study aims to investigate the impact of TMZ on myocardial damage in mice exhibiting diabetic cardiomyopathy (DCM), and to furnish a laboratory foundation for the clinical treatment of diabetic cardiomyopathy.
Method
Male db/db mice (6 weeks old, n = 21) and male wild-type (wt) (6 weeks old, n = 20) mice were selected for the study. The wt mice were randomly assigned to the wt group (n = 10) and wt + TMZ group (n = 10), while the remaining db/db mice were randomly allocated to the db/db group (n = 11) and db/db + TMZ group (n = 10). Following 8 weeks of feeding, the wt + TMZ group and db/db + TMZ group received TMZ via gavage, whereas the remaining groups were administered physiological saline. Periodic measurements of blood glucose, blood lipids, and myocardial enzymes were conducted in mice, with samples obtained after the 12th week for subsequent biochemical analysis, myocardial pathology assessment, immunohistochemistry, western blot analysis, and TUNEL staining (TdT-mediated dUTP Nick-End Labeling).
Result
GLU, TC, TG, LDL-C, and CK-MB levels were significantly higher in db/db mice compared to wt mice (GLU: M ± SD wt 5.94 ± 0.37, db/db 17.63 ± 0.89, p < 0.05, ES = 0.991; TC: M ± SD wt 3.01 ± 0.32, db/db 6.97 ± 0.36, p < 0.05, ES = 0.972; TG: M ± SD wt 0.58 ± 0.2, db/db 1.75 ± 0.14, p < 0.05, ES = 0.920; LDL-C: M ± SD wt 1.59 ± 0.12, db/db 3.87 ± 0.14, p < 0.05, ES = 0.989; CK-MB: M ± SD wt 0.12 ± 0.01, db/db 0.31 ± 0.04, p < 0.05, ES = 0.928). HDL-C levels were significantly lower in db/db mice (M ± SD wt 1.89 ± 0.08, db/db 0.64 ± 0.09, p < 0.05, ES = 0.963). Histopathological analysis confirmed myocardial damage in db/db mice. Treatment with TMZ reduced GLU, TC, TG, LDL-C, and CK-MB levels (p < 0.05, ES > 0.9) and increased HDL-C levels compared to
{"title":"Influence of trimetazidine on myocardial injury in mice with diabetic cardiomyopathy","authors":"Dongming Zhao , Jingming Ma , Yuman Sun , Wei Huang , Jinyang Fan , Mingzhe Ye , Bo Hu , Xinyi Sun","doi":"10.1016/j.jdiacomp.2024.108744","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108744","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of diabetes mellitus is increasing year by year globally, and diabetic cardiomyopathy (DCM), as the most common complication of type 2 diabetes mellitus, seriously affects the prognosis of patients. Trimetazidine (TMZ), as a drug affecting myocardial energy metabolism, mainly reduces the oxidation rate of β-oxidation by inhibiting 3-ketoacyl-CoA thiolase (3-KAT), a key enzyme in β-oxidation of free fatty acid (FFA), so that the energy metabolism substrate of cardiomyocytes preferentially selects glucose rather than fatty acids, increases the content of intracellular adenosine triphosphate (ATP), enhances the contractile function of cardiomyocytes, and improves the state of cellular ischemia and hypoxia. Previous studies have shown that TMZ is closely related to the activation and induction of apoptosis of the MAPK pathway and AMPK pathway, and plays a role in the treatment of diabetic cardiomyopathy, but the specific mechanism is still unclear.</p></div><div><h3>Objective</h3><p>This study aims to investigate the impact of TMZ on myocardial damage in mice exhibiting diabetic cardiomyopathy (DCM), and to furnish a laboratory foundation for the clinical treatment of diabetic cardiomyopathy.</p></div><div><h3>Method</h3><p>Male db/db mice (6 weeks old, <em>n</em> = 21) and male wild-type (wt) (6 weeks old, <em>n</em> = 20) mice were selected for the study. The wt mice were randomly assigned to the wt group (<em>n</em> = 10) and wt + TMZ group (<em>n</em> = 10), while the remaining db/db mice were randomly allocated to the db/db group (<em>n</em> = 11) and db/db + TMZ group (n = 10). Following 8 weeks of feeding, the wt + TMZ group and db/db + TMZ group received TMZ via gavage, whereas the remaining groups were administered physiological saline. Periodic measurements of blood glucose, blood lipids, and myocardial enzymes were conducted in mice, with samples obtained after the 12th week for subsequent biochemical analysis, myocardial pathology assessment, immunohistochemistry, western blot analysis, and TUNEL staining (TdT-mediated dUTP Nick-End Labeling).</p></div><div><h3>Result</h3><p>GLU, TC, TG, LDL-C, and CK-MB levels were significantly higher in db/db mice compared to wt mice (GLU: M ± SD wt 5.94 ± 0.37, db/db 17.63 ± 0.89, <em>p</em> < 0.05, ES = 0.991; TC: M ± SD wt 3.01 ± 0.32, db/db 6.97 ± 0.36, <em>p</em> < 0.05, ES = 0.972; TG: M ± SD wt 0.58 ± 0.2, db/db 1.75 ± 0.14, <em>p</em> < 0.05, ES = 0.920; LDL-C: M ± SD wt 1.59 ± 0.12, db/db 3.87 ± 0.14, <em>p</em> < 0.05, ES = 0.989; CK-MB: M ± SD wt 0.12 ± 0.01, db/db 0.31 ± 0.04, <em>p</em> < 0.05, ES = 0.928). HDL-C levels were significantly lower in db/db mice (M ± SD wt 1.89 ± 0.08, db/db 0.64 ± 0.09, p < 0.05, ES = 0.963). Histopathological analysis confirmed myocardial damage in db/db mice. Treatment with TMZ reduced GLU, TC, TG, LDL-C, and CK-MB levels (<em>p</em> < 0.05, ES > 0.9) and increased HDL-C levels compared to ","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140549557","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}
Pub Date : 2024-04-04DOI: 10.1016/j.jdiacomp.2024.108743
Wanrun Xie, Zhenzhen Hong, Bo Li, Baoliang Huang, Shaobin Dong, Yuqi Cai, Lingyan Ruan, Qianhui Xu, Lunpan Mou, Yi Zhang
Aim
This systematic review and meta-analysis aimed to comprehensively evaluate the impact of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in individuals with diabetes mellitus and non-alcoholic fatty liver disease (NAFLD) or obesity.
Methods
A search of PubMed, Embase, and Web of Science until October 2023 identified 13 Randomized Controlled Trials (RCTs) meeting the inclusion criteria. Bias risk was assessed using the Cochrane risk-of-bias instrument. Statistical analysis utilized standard mean differences (SMD) in Review Manager 5.4. Heterogeneity and publication bias were assessed. This study used the protocol registered with the Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY2023110020).
Results
GLP-1RA treatment significantly reduced VAT (SMD −0.55, 95 % CI [−0.90, −0.19]), SAT (SMD −0.59, 95 % CI [−0.99, −0.19]), body weight (SMD −1.07, 95 % CI [−1.67, −0.47]), and body mass index (BMI) (SMD −1.10, 95 % CI [−1.74, −0.47]) compared to controls. Heterogeneity was observed for VAT (I2 = 79 %, P < 0.01), SAT (I2 = 73 %, P < 0.01), body weight (I2 = 82 %, P < 0.01), and BMI (I2 = 82 %, P < 0.01). No publication bias was detected for VAT (P = 0.57) and SAT (P = 0.18). GLP-1RA treatment improved fasting blood glucose (FBG), postprandial glucose (PPG), hemoglobin A1c (HbA1c), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and fibrosis-4 (FIB-4).
Conclusions
This meta-analysis highlights GLP-1RAs' potential to reduce fat accumulation, body weight, and BMI and improve glycemic control in individuals with diabetes mellitus and NAFLD or obesity. These findings supported using GLP-1RAs as promising therapeutic agents to address abnormal adipose tissue distribution and metabolic dysfunction.
目的本系统综述和荟萃分析旨在全面评估胰高血糖素样肽 1 受体激动剂(GLP-1RAs)对糖尿病合并非酒精性脂肪肝(NAFLD)或肥胖症患者的内脏脂肪组织(VAT)和皮下脂肪组织(SAT)的影响。方法截至 2023 年 10 月,通过对 PubMed、Embase 和 Web of Science 的检索,共发现 13 项符合纳入标准的随机对照试验(RCT)。偏倚风险采用 Cochrane 偏倚风险工具进行评估。统计分析使用了 Review Manager 5.4 中的标准平均差 (SMD)。对异质性和发表偏倚进行了评估。结果GLP-1RA治疗显著降低了VAT(SMD -0.55, 95 % CI [-0.90,-0.19])、SAT(SMD -0.59,95 % CI [-0.99,-0.19])、体重(SMD -1.07,95 % CI [-1.67,-0.47])和体质指数(BMI)(SMD -1.10,95 % CI [-1.74,-0.47])。VAT (I2 = 79 %, P < 0.01)、SAT (I2 = 73 %, P < 0.01)、体重 (I2 = 82 %, P < 0.01) 和 BMI (I2 = 82 %, P < 0.01)存在异质性。VAT (P = 0.57) 和 SAT (P = 0.18) 未发现发表偏倚。GLP-1RA 治疗改善了空腹血糖 (FBG)、餐后血糖 (PPG)、血红蛋白 A1c (HbA1c)、胰岛素抵抗自律模型评估 (HOMA-IR) 和纤维化-4 (FIB-4)。这些研究结果支持将 GLP-1RAs 作为有前景的治疗药物,以解决脂肪组织分布异常和代谢功能障碍问题。
{"title":"Influence of glucagon-like peptide-1 receptor agonists on fat accumulation in patients with diabetes mellitus and non-alcoholic fatty liver disease or obesity: A systematic review and meta-analysis of randomized control trials","authors":"Wanrun Xie, Zhenzhen Hong, Bo Li, Baoliang Huang, Shaobin Dong, Yuqi Cai, Lingyan Ruan, Qianhui Xu, Lunpan Mou, Yi Zhang","doi":"10.1016/j.jdiacomp.2024.108743","DOIUrl":"10.1016/j.jdiacomp.2024.108743","url":null,"abstract":"<div><h3>Aim</h3><p>This systematic review and meta-analysis aimed to comprehensively evaluate the impact of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in individuals with diabetes mellitus and non-alcoholic fatty liver disease (NAFLD) or obesity.</p></div><div><h3>Methods</h3><p>A search of PubMed, Embase, and Web of Science until October 2023 identified 13 Randomized Controlled Trials (RCTs) meeting the inclusion criteria. Bias risk was assessed using the Cochrane risk-of-bias instrument. Statistical analysis utilized standard mean differences (SMD) in Review Manager 5.4. Heterogeneity and publication bias were assessed. This study used the protocol registered with the Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY2023110020).</p></div><div><h3>Results</h3><p>GLP-1RA treatment significantly reduced VAT (SMD −0.55, 95 % CI [−0.90, −0.19]), SAT (SMD −0.59, 95 % CI [−0.99, −0.19]), body weight (SMD −1.07, 95 % CI [−1.67, −0.47]), and body mass index (BMI) (SMD −1.10, 95 % CI [−1.74, −0.47]) compared to controls. Heterogeneity was observed for VAT (I<sup>2</sup> = 79 %, <em>P</em> < 0.01), SAT (I<sup>2</sup> = 73 %, <em>P</em> < 0.01), body weight (I<sup>2</sup> = 82 %, <em>P</em> < 0.01), and BMI (I<sup>2</sup> = 82 %, <em>P</em> < 0.01). No publication bias was detected for VAT (<em>P</em> = 0.57) and SAT (<em>P</em> = 0.18). GLP-1RA treatment improved fasting blood glucose (FBG), postprandial glucose (PPG), hemoglobin A1c (HbA1c), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and fibrosis-4 (FIB-4).</p></div><div><h3>Conclusions</h3><p>This meta-analysis highlights GLP-1RAs' potential to reduce fat accumulation, body weight, and BMI and improve glycemic control in individuals with diabetes mellitus and NAFLD or obesity. These findings supported using GLP-1RAs as promising therapeutic agents to address abnormal adipose tissue distribution and metabolic dysfunction.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786569","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}
Pub Date : 2024-04-03DOI: 10.1016/j.jdiacomp.2024.108742
Abraham Edgar Gracia-Ramos , María del Pilar Cruz-Dominguez , Eduardo Osiris Madrigal-Santillán , Raúl Rojas-Martínez , José Antonio Morales-González , Ángel Morales-González , Mónica Hernández-Espinoza , Joaquín Vargas-Peñafiel , María de los Ángeles Tapia-González
Aims
To compare the efficacy and safety of basal-plus (BP) insulin regimen with or without sitagliptin in non-critically ill patients with type 2 diabetes (T2D).
Methods
This open-label, randomized clinical trial included inpatients with a previous diagnosis of T2D and blood glucose (BG) between 180 and 400 mg/dL. Participants received basal and correctional insulin doses (BP regimen) either with or without sitagliptin. The primary outcome was the difference in the mean daily BG among the groups.
Results
Seventy-six patients (mean age 60 years, 64 % men) were randomized. Compared with BP insulin therapy alone, the sitagliptin-BP combination led to a lower mean daily BG (158.8 vs 175.0 mg/dL, P = 0.014), a higher percentage of readings within a BG range of 70–180 mg/dL (75.9 % vs 64.7 %, P < 0.001), and a lower number of BG readings >180 mg/dL (P < 0.001). Sitagliptin-BP resulted in fewer basal and supplementary insulin doses (P = 0.024 and P = 0.017, respectively) and lower daily insulin injections (P = 0.023) than those with insulin alone. The proportion of patients with hypoglycemia was similar in the two groups.
Conclusions
For inpatients with T2D and hyperglycemia, the sitagliptin and BP regimen combination is safe and more effective than insulin therapy alone.
Clinicaltrials.gov identifier: NCT05579119
目的比较基础胰岛素加(BP)方案联合或不联合西格列汀对非重症 2 型糖尿病(T2D)患者的疗效和安全性。方法这项开放标签、随机临床试验纳入了既往诊断为 T2D 且血糖(BG)在 180 至 400 mg/dL 之间的住院患者。参与者在使用或不使用西格列汀的情况下接受基础和修正胰岛素剂量(BP 方案)。结果76名患者(平均年龄60岁,64%为男性)接受了随机治疗。与单用胰岛素血压疗法相比,西格列汀-BP联合疗法的日平均血糖值更低(158.8 vs 175.0 mg/dL,P = 0.014),血糖值在70-180 mg/dL范围内的读数百分比更高(75.9 % vs 64.7 %,P <0.001),血糖值在>180 mg/dL范围内的读数更少(P <0.001)。与单独使用胰岛素的患者相比,西他列汀-BP 可减少基础胰岛素和补充胰岛素剂量(P = 0.024 和 P = 0.017),降低每日胰岛素注射量(P = 0.023)。结论对于患有 T2D 和高血糖的住院患者,西格列汀和 BP 方案组合比单独使用胰岛素治疗安全有效:NCT05579119
{"title":"Efficacy and safety of sitagliptin with basal-plus insulin regimen versus insulin alone in non-critically ill hospitalized patients with type 2 diabetes: SITA-PLUS hospital trial","authors":"Abraham Edgar Gracia-Ramos , María del Pilar Cruz-Dominguez , Eduardo Osiris Madrigal-Santillán , Raúl Rojas-Martínez , José Antonio Morales-González , Ángel Morales-González , Mónica Hernández-Espinoza , Joaquín Vargas-Peñafiel , María de los Ángeles Tapia-González","doi":"10.1016/j.jdiacomp.2024.108742","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108742","url":null,"abstract":"<div><h3>Aims</h3><p>To compare the efficacy and safety of basal-plus (BP) insulin regimen with or without sitagliptin in non-critically ill patients with type 2 diabetes (T2D).</p></div><div><h3>Methods</h3><p>This open-label, randomized clinical trial included inpatients with a previous diagnosis of T2D and blood glucose (BG) between 180 and 400 mg/dL. Participants received basal and correctional insulin doses (BP regimen) either with or without sitagliptin. The primary outcome was the difference in the mean daily BG among the groups.</p></div><div><h3>Results</h3><p>Seventy-six patients (mean age 60 years, 64 % men) were randomized. Compared with BP insulin therapy alone, the sitagliptin-BP combination led to a lower mean daily BG (158.8 <em>vs</em> 175.0 mg/dL, <em>P</em> = 0.014), a higher percentage of readings within a BG range of 70–180 mg/dL (75.9 % <em>vs</em> 64.7 %, <em>P</em> < 0.001), and a lower number of BG readings >180 mg/dL (<em>P</em> < 0.001). Sitagliptin-BP resulted in fewer basal and supplementary insulin doses (<em>P</em> = 0.024 and <em>P</em> = 0.017, respectively) and lower daily insulin injections (<em>P</em> = 0.023) than those with insulin alone. The proportion of patients with hypoglycemia was similar in the two groups.</p></div><div><h3>Conclusions</h3><p>For inpatients with T2D and hyperglycemia, the sitagliptin and BP regimen combination is safe and more effective than insulin therapy alone.</p><p><span>Clinicaltrials.gov</span><svg><path></path></svg> identifier: <span>NCT05579119</span><svg><path></path></svg></p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350764","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}
{"title":"Managing cardio-renal-metabolic risk in patients with type 2 diabetes: the role of finerenone","authors":"Tiziana Filardi , Alessandra Feraco , Antoine Ouvrard-Pascaud , Manfredi Rizzo , Massimiliano Caprio","doi":"10.1016/j.jdiacomp.2024.108741","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108741","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341613","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}
Pub Date : 2024-03-27DOI: 10.1016/j.jdiacomp.2024.108737
Fengmin Liu , Fangqin You , Lihang Yang , Siyun Wang , Diya Xie
Purpose
Diabetic neuropathy (DN) is a notable complication of diabetes mellitus. The potential involvement of miR-146a in DN regulation is presently under investigation. Metformin, a commonly prescribed medication for diabetes, is the primary therapeutic intervention. This study aimed to unveil the potential protective effects of metformin on diabetic neuropathy and explore the mechanisms underlying its action.
Method
Six-weeks male Sprague Dawley rats (n = 40) were randomly divided into 5 groups. The rat model of diabetic neuropathy (DN) was established by administering streptozotocin (STZ). To investigate the effects on the sciatic nerve and resident Schwann cells (RSCs), metformin and miR-146a mimics were administered, and our research explored the potential underlying mechanism.
Result
The sciatic nerve samples obtained from diabetic rats exhibited noticeable morphological damage, accompanied by decreased miR-146a expression (2.61 ± 0.11 vs 5.0 ± 0.3, p < 0.01) and increased inflammation levels (p65: 1.89 ± 0.04 vs 0.82 ± 0.05, p < 0.01; TNF-α: 0.93 ± 0.03 vs 0.33 ± 0.03, p < 0.01). Notably, the administration of metformin effectively ameliorated the structural alterations in the sciatic nerve by suppressing the inflammatory pathway (p65: 1.15 ± 0.05 vs 1.89 ± 0.04, p < 0.01; TNF-α: 0.67 ± 0.04 vs 0.93 ± 0.03, p < 0.01) and reducing oxidative stress (NO: 0.062 ± 0.004 vs 0.154 ± 0.004umol/mg, p < 0.01; SOD: 3.08 ± 0.09 vs 2.46 ± 0.09 U/mg, p < 0.01). The miR-146a mimics intervention group exhibited comparable findings.
Conclusion
This study's findings implied that metformin can potentially mitigate diabetic neuropathy in rats through the modulation of miR-146a expression.
目的糖尿病神经病变(DN)是糖尿病的一种明显并发症。目前正在研究 miR-146a 在 DN 调节中的潜在参与。二甲双胍是糖尿病的常用处方药,是主要的治疗干预措施。本研究旨在揭示二甲双胍对糖尿病神经病变的潜在保护作用,并探索其作用机制。给大鼠注射链脲佐菌素(STZ),建立糖尿病神经病变(DN)模型。为了研究二甲双胍和 miR-146a 模拟物对坐骨神经和常驻许旺细胞(RSCs)的影响,我们的研究探讨了其潜在的内在机制。结果糖尿病大鼠的坐骨神经样本表现出明显的形态学损伤,同时伴有 miR-146a 表达的降低(2.61 ± 0.11 vs 5.0 ± 0.3,p < 0.01)和炎症水平的升高(p65: 1.89 ± 0.04 vs 0.82 ± 0.05,p < 0.01;TNF-α:0.93 ± 0.03 vs 0.33 ± 0.03, p < 0.01)。值得注意的是,二甲双胍能通过抑制炎症途径有效改善坐骨神经的结构改变(p65:1.15 ± 0.05 vs 1.89 ± 0.04,p <;0.01;TNF-α:0.67 ± 0.04 vs 0.93 ± 0.03, p < 0.01)和减少氧化应激(NO: 0.062 ± 0.004 vs 0.154 ± 0.004umol/mg, p < 0.01; SOD: 3.08 ± 0.09 vs 2.46 ± 0.09 U/mg, p < 0.01)。结论 本研究结果表明,二甲双胍可通过调节 miR-146a 的表达减轻大鼠糖尿病神经病变。
{"title":"Metformin improves diabetic neuropathy by reducing inflammation through up-regulating the expression of miR-146a and suppressing oxidative stress","authors":"Fengmin Liu , Fangqin You , Lihang Yang , Siyun Wang , Diya Xie","doi":"10.1016/j.jdiacomp.2024.108737","DOIUrl":"10.1016/j.jdiacomp.2024.108737","url":null,"abstract":"<div><h3>Purpose</h3><p>Diabetic neuropathy (DN) is a notable complication of diabetes mellitus. The potential involvement of miR-146a in DN regulation is presently under investigation. Metformin, a commonly prescribed medication for diabetes, is the primary therapeutic intervention. This study aimed to unveil the potential protective effects of metformin on diabetic neuropathy and explore the mechanisms underlying its action.</p></div><div><h3>Method</h3><p>Six-weeks male Sprague Dawley rats (<em>n</em> = 40) were randomly divided into 5 groups. The rat model of diabetic neuropathy (DN) was established by administering streptozotocin (STZ). To investigate the effects on the sciatic nerve and resident Schwann cells (RSCs), metformin and miR-146a mimics were administered, and our research explored the potential underlying mechanism.</p></div><div><h3>Result</h3><p>The sciatic nerve samples obtained from diabetic rats exhibited noticeable morphological damage, accompanied by decreased miR-146a expression (2.61 ± 0.11 vs 5.0 ± 0.3, <em>p</em> < 0.01) and increased inflammation levels (p65: 1.89 ± 0.04 vs 0.82 ± 0.05, <em>p</em> < 0.01; TNF-α: 0.93 ± 0.03 vs 0.33 ± 0.03, p < 0.01). Notably, the administration of metformin effectively ameliorated the structural alterations in the sciatic nerve by suppressing the inflammatory pathway (p65: 1.15 ± 0.05 vs 1.89 ± 0.04, <em>p</em> < 0.01; TNF-α: 0.67 ± 0.04 vs 0.93 ± 0.03, <em>p</em> < 0.01) and reducing oxidative stress (NO: 0.062 ± 0.004 vs 0.154 ± 0.004umol/mg, <em>p</em> < 0.01; SOD: 3.08 ± 0.09 vs 2.46 ± 0.09 U/mg, p < 0.01). The miR-146a mimics intervention group exhibited comparable findings.</p></div><div><h3>Conclusion</h3><p>This study's findings implied that metformin can potentially mitigate diabetic neuropathy in rats through the modulation of miR-146a expression.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724000631/pdfft?md5=2585500751e9c93b148c0660e5c27001&pid=1-s2.0-S1056872724000631-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402335","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}