Pub Date : 2025-10-21DOI: 10.1016/j.jdiacomp.2025.109205
Fulden Sari , Zilan Bazancir-Apaydın , Süleyman Sari , Mehmet Can Sari , Şenol Çelik
Aim
Swallowing difficulties are increasingly recognized as a significant yet underreported complication of diabetes mellitus (DM), with evidence suggesting that more than 50 % of patients with the condition may be affected. This study aimed to assess the impact of swallowing disorders on the quality of life in DM patients, to identify other factors influencing swallowing disorders, and to determine the cut-off score for the SWAL-QOL questionnaire in these patients using data mining methods.
Methods
This cross-sectional study analyzed 150 DM patients, assessing swallowing assessment using the EAT-10, quality of life with the SWAL-QOL, and swallowing difficulty through the Visual Analogue Scale (VAS).
Results
Patients with dysphagia exhibited significantly lower scores across multiple SWAL-QOL subgroups-including General Burden, Food Selection, Eating Duration, Eating Desire, Fear of Eating, Sleep, Fatigue, Communication, Mental Health, Social Functioning, and the total SWAL-QOL score compared to non-dysphagic patients (p < 0.001). The Swallowing Difficulty-VAS score was significantly elevated in dysphagic patients (p < 0.001). EAT-10 scores were correlated with Swallowing Difficulty-VAS and SWAL-QOL subgroups, including General Burden, Food Selection, Eating Duration, Eating Desire, Fear of Eating, Sleep, Fatigue, Communication, Mental Health, Social Functioning, and the total score. The SWAL-QOL total score cut-off of 65.7 was identified for DM patients with dysphagia.
Conclusions
Close monitoring of these symptoms by clinicians is essential, and targeted rehabilitation interventions are strongly recommended to improve both swallowing function and overall quality of life in this population.
{"title":"Assessing the impact of dysphagia on quality of life and determining SWAL-QOL cut-off scores in diabetes mellitus patients: a data mining approach","authors":"Fulden Sari , Zilan Bazancir-Apaydın , Süleyman Sari , Mehmet Can Sari , Şenol Çelik","doi":"10.1016/j.jdiacomp.2025.109205","DOIUrl":"10.1016/j.jdiacomp.2025.109205","url":null,"abstract":"<div><h3>Aim</h3><div>Swallowing difficulties are increasingly recognized as a significant yet underreported complication of diabetes mellitus (DM), with evidence suggesting that more than 50 % of patients with the condition may be affected. This study aimed to assess the impact of swallowing disorders on the quality of life in DM patients, to identify other factors influencing swallowing disorders, and to determine the cut-off score for the SWAL-QOL questionnaire in these patients using data mining methods.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed 150 DM patients, assessing swallowing assessment using the EAT-10, quality of life with the SWAL-QOL, and swallowing difficulty through the Visual Analogue Scale (VAS).</div></div><div><h3>Results</h3><div>Patients with dysphagia exhibited significantly lower scores across multiple SWAL-QOL subgroups-including General Burden, Food Selection, Eating Duration, Eating Desire, Fear of Eating, Sleep, Fatigue, Communication, Mental Health, Social Functioning, and the total SWAL-QOL score compared to non-dysphagic patients (p < 0.001). The Swallowing Difficulty-VAS score was significantly elevated in dysphagic patients (p < 0.001). EAT-10 scores were correlated with Swallowing Difficulty-VAS and SWAL-QOL subgroups, including General Burden, Food Selection, Eating Duration, Eating Desire, Fear of Eating, Sleep, Fatigue, Communication, Mental Health, Social Functioning, and the total score. The SWAL-QOL total score cut-off of 65.7 was identified for DM patients with dysphagia.</div></div><div><h3>Conclusions</h3><div>Close monitoring of these symptoms by clinicians is essential, and targeted rehabilitation interventions are strongly recommended to improve both swallowing function and overall quality of life in this population.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109205"},"PeriodicalIF":3.1,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145359893","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 : 2025-10-20DOI: 10.1016/j.jdiacomp.2025.109202
Salwa Dilfari Pohan , Rani Sauriasari , Baitha Palanggatan Maggadani , Taufiq Indra Rukmana , Farah Mahdiyah , Fathia Yusrina , Sri Hayati , Richard Johari James , Mohd Salleh Rofiee , Teh Lay Kek , Mohd Zaki Salleh
Objectives
This study investigated the relationship between serum metabolomic profiles and diabetic kidney disease (DKD) risk in patients with type 2 diabetes mellitus (T2DM) stratified into three KDIGO-defined risk categories.
Methods
Serum samples from 48 patients were analyzed using untargeted liquid chromatography–quadrupole time-of-flight mass spectrometry (LC-QTOF/MS). Participants were classified into low (n = 16), moderate (n = 16), and high (n = 16) DKD risk groups according to KDIGO guidelines. Differential metabolites were identified based on p-value, log fold change, and variable importance in projection (VIP), and subsequently subjected to pathway enrichment analysis.
Results
Comparative analysis revealed five differential metabolites between low- and moderate-risk groups, three between moderate- and high-risk groups, and three between low- and high-risk groups. Notably, sphinganine, arachidonic acid, and ornithine were progressively downregulated, whereas AFMK, L-arginine, lactosylceramide (LacCer), and lysophosphatidylcholine (lysoPC) were upregulated with increasing DKD risk. These metabolites mapped to disturbed pathways, including arginine and proline metabolism, sphingolipid metabolism, glycerophospholipid metabolism, arachidonic acid metabolism, and tryptophan metabolism.
Conclusion
This study highlights progressive alterations in amino acid, lipid, and inflammatory pathways across DKD risk categories, suggesting that these stage-specific metabolomic signatures may serve as putative biomarkers for detection and monitoring of DKD progression in T2DM.
{"title":"Serum analysis of type 2 diabetes mellitus patients with low, moderate, and high risk of diabetic kidney disease using LC-MS metabolomics approach","authors":"Salwa Dilfari Pohan , Rani Sauriasari , Baitha Palanggatan Maggadani , Taufiq Indra Rukmana , Farah Mahdiyah , Fathia Yusrina , Sri Hayati , Richard Johari James , Mohd Salleh Rofiee , Teh Lay Kek , Mohd Zaki Salleh","doi":"10.1016/j.jdiacomp.2025.109202","DOIUrl":"10.1016/j.jdiacomp.2025.109202","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the relationship between serum metabolomic profiles and diabetic kidney disease (DKD) risk in patients with type 2 diabetes mellitus (T2DM) stratified into three KDIGO-defined risk categories.</div></div><div><h3>Methods</h3><div>Serum samples from 48 patients were analyzed using untargeted liquid chromatography–quadrupole time-of-flight mass spectrometry (LC-QTOF/MS). Participants were classified into low (<em>n</em> = 16), moderate (n = 16), and high (n = 16) DKD risk groups according to KDIGO guidelines. Differential metabolites were identified based on <em>p</em>-value, log fold change, and variable importance in projection (VIP), and subsequently subjected to pathway enrichment analysis.</div></div><div><h3>Results</h3><div>Comparative analysis revealed five differential metabolites between low- and moderate-risk groups, three between moderate- and high-risk groups, and three between low- and high-risk groups. Notably, sphinganine, arachidonic acid, and ornithine were progressively downregulated, whereas AFMK, L-arginine, lactosylceramide (LacCer), and lysophosphatidylcholine (lysoPC) were upregulated with increasing DKD risk. These metabolites mapped to disturbed pathways, including arginine and proline metabolism, sphingolipid metabolism, glycerophospholipid metabolism, arachidonic acid metabolism, and tryptophan metabolism.</div></div><div><h3>Conclusion</h3><div>This study highlights progressive alterations in amino acid, lipid, and inflammatory pathways across DKD risk categories, suggesting that these stage-specific metabolomic signatures may serve as putative biomarkers for detection and monitoring of DKD progression in T2DM.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109202"},"PeriodicalIF":3.1,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569414","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 : 2025-10-19DOI: 10.1016/j.jdiacomp.2025.109203
Sameer Badri Al-Mhanna , Barry A. Franklin , John M. Jakicic , Emmanuel Stamatakis , Linda S. Pescatello , Deborah Riebe , Walter R. Thompson , James S. Skinner , Sheri R. Colberg , Jonathan K. Ehrman , George S. Metsios , Norsuhana Omar , Nouf H. Alkhamees , Bodor Bin Sheeha , Abdullah F. Alghannam , Alexios Batrakoulis
Purpose
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity).
Methods
PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity.
Results
A total of 1391 middle-aged/older adult patients (55 % females) were included in 34 RCTs. Body mass index [standardized mean differences (SMD) -0.18 kg/m2, 95 % confidence intervals (CI) -0.36 to −0.01]. waist circumference (SMD -0.23 cm, 95 % CI -0.44 to −0.03), body fat (SMD -0.30 %, 95 % CI -0.59 to −0.01), fasting blood glucose (SMD -0.49 mmol/L, 95 % CI -0.72 to −0.27), glycated hemoglobin (SMD -0.79 %, 95 % CI -1.17 to −0.41), fasting insulin (SMD -0.44 mIU/L, 95 % CI -0.72 to −0.15), homeostatic model assessment for insulin resistance (SMD -0.72, 95 % CI -1.09 to −0.35), high-density lipoprotein cholesterol (SMD 0.32 mg/dL, 95 % CI 0.01 to 0.63), triglycerides (SMD -0.33 mg/dL, 95 % CI -0.63 to −0.04), and total cholesterol (SMD -0.28 mg/dL, 95 % CI -0.47 to −0.10) improved compared with standard treatment.
Conclusions
These results underscore the beneficial role of aerobic exercise as a non-pharmacological intervention in managing and treating patients with diabesity when compared to standard treatment, despite the presence of considerable uncertainty in several outcomes.
目的对随机对照试验（RCTs）进行系统回顾和荟萃分析，旨在评估有氧运动对2型糖尿病合并超重/肥胖（糖尿病）患者心脏代谢相关指标的影响。方法检索spubmed、Web of Science、Scopus、Science Direct、Cochrane Library和谷歌Scholar数据库，检索时间为建库至2024年10月。搜索策略包括以下关键词：糖尿病、有氧运动和耐力训练。比较持续时间≥2周的有氧运动训练与标准治疗的rct被认为是合格的。参与者是患有糖尿病的成年人。结果34项随机对照试验共纳入1391例中老年患者，其中女性占55%。体重指数[标准化平均差(SMD) -0.18 kg/m2, 95%置信区间(CI) -0.36至- 0.01]。腰围(SMD -0.23厘米,95% CI -0.44−0.03),脂肪(SMD -0.30%, 95% CI -0.59−0.01)、空腹血糖(SMD -0.49更易/ L, 95%置信区间-0.72 - 0.27−)、糖化血红蛋白(SMD -0.79%, 95% CI -1.17−0.41)、空腹胰岛素(SMD -0.44个人/ L, 95% CI -0.72−0.15),稳态模型评估胰岛素抵抗(SMD -0.72, 95% CI -1.09−0.35),高密度脂蛋白胆固醇(SMD 0.32 mg / dL, 95%可信区间0.01到0.63),甘油三酯(SMD -0.33 mg / dL,95% CI -0.63至- 0.04)，总胆固醇（SMD -0.28 mg/dL, 95% CI -0.47至- 0.10）与标准治疗相比有所改善。结论：与标准治疗相比，这些结果强调了有氧运动作为一种非药物干预在管理和治疗糖尿病患者方面的有益作用，尽管在一些结果中存在相当大的不确定性。
{"title":"Impact of aerobic exercise on cardiometabolic health in patients with diabesity: A systematic review and meta-analysis of randomized controlled trials","authors":"Sameer Badri Al-Mhanna , Barry A. Franklin , John M. Jakicic , Emmanuel Stamatakis , Linda S. Pescatello , Deborah Riebe , Walter R. Thompson , James S. Skinner , Sheri R. Colberg , Jonathan K. Ehrman , George S. Metsios , Norsuhana Omar , Nouf H. Alkhamees , Bodor Bin Sheeha , Abdullah F. Alghannam , Alexios Batrakoulis","doi":"10.1016/j.jdiacomp.2025.109203","DOIUrl":"10.1016/j.jdiacomp.2025.109203","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity).</div></div><div><h3>Methods</h3><div>PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity.</div></div><div><h3>Results</h3><div>A total of 1391 middle-aged/older adult patients (55 % females) were included in 34 RCTs. Body mass index [standardized mean differences (SMD) -0.18 kg/m<sup>2</sup>, 95 % confidence intervals (CI) -0.36 to −0.01]. waist circumference (SMD -0.23 cm, 95 % CI -0.44 to −0.03), body fat (SMD -0.30 %, 95 % CI -0.59 to −0.01), fasting blood glucose (SMD -0.49 mmol/L, 95 % CI -0.72 to −0.27), glycated hemoglobin (SMD -0.79 %, 95 % CI -1.17 to −0.41), fasting insulin (SMD -0.44 mIU/L, 95 % CI -0.72 to −0.15), homeostatic model assessment for insulin resistance (SMD -0.72, 95 % CI -1.09 to −0.35), high-density lipoprotein cholesterol (SMD 0.32 mg/dL, 95 % CI 0.01 to 0.63), triglycerides (SMD -0.33 mg/dL, 95 % CI -0.63 to −0.04), and total cholesterol (SMD -0.28 mg/dL, 95 % CI -0.47 to −0.10) improved compared with standard treatment.</div></div><div><h3>Conclusions</h3><div>These results underscore the beneficial role of aerobic exercise as a non-pharmacological intervention in managing and treating patients with diabesity when compared to standard treatment, despite the presence of considerable uncertainty in several outcomes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109203"},"PeriodicalIF":3.1,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145359892","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 : 2025-10-18DOI: 10.1016/j.jdiacomp.2025.109201
Yasmine Ibrahim Elhenawy , Rasha Adel Thabet , Marwa G.A. Hegazy , Shymaa Ayed El-Morsy , Yasmeen AbdelAziz Fereig
Aim
Evaluate the oxidant-antioxidant balance and the efficacy of Alpha-lipoic acid (ALA) as an adjuvant therapy for diabetic nephropathy (DN) among individuals with type 1 diabetes (T1D).
Materials and methods
A 3 months prospective randomized controlled trial including 50 participants with DN randomly allocated (1:1) to one of two arms; an interventional arm receiving 300 mg/day of ALA (n = 25) and a non-interventional arm (n = 25). Initial assessments included HbA1c, urinary albumin excretion rate (UAER), malondialdehyde (MDA), and total antioxidant capacity (TAC). Baseline data was compared with 50 participants with T1D without DN and 50 healthy controls.
Results
T1D participants had significantly higher MDA and lower TAC levels compared to controls (P < 0.01). Within the T1D cohort, participants with DN showed significantly higher MDA and lower TAC levels (P < 0.01). MDA positively correlated with triglycerides (r = 0.53), UAER (r = 0.70), and HbA1c (r = 0.5) (p < 0.01), while TAC negatively correlated triglycerides (r = −0.41), UAER (r = −0.88), and HbA1c (r = −0.64) (p < 0.01). After 3 months of ALA supplementation, significant reductions in HbA1c, UAER, and MDA were observed, along with an increase in TAC (P < 0.01).
Conclusion
The study demonstrates that 3 months of ALA supplementation effectively reduced oxidative stress and UAER, demonstrating a potential role in protecting renal tissue from diabetes-induced oxidative damage.
{"title":"The role of oral alpha-lipoic acid as an adjuvant antioxidant therapy in diabetic nephropathy among children and adolescents with type 1 diabetes: a randomized controlled trial","authors":"Yasmine Ibrahim Elhenawy , Rasha Adel Thabet , Marwa G.A. Hegazy , Shymaa Ayed El-Morsy , Yasmeen AbdelAziz Fereig","doi":"10.1016/j.jdiacomp.2025.109201","DOIUrl":"10.1016/j.jdiacomp.2025.109201","url":null,"abstract":"<div><h3>Aim</h3><div>Evaluate the oxidant-antioxidant balance and the efficacy of Alpha-lipoic acid (ALA) as an adjuvant therapy for diabetic nephropathy (DN) among individuals with type 1 diabetes (T1D).</div></div><div><h3>Materials and methods</h3><div>A 3 months prospective randomized controlled trial including 50 participants with DN randomly allocated (1:1) to one of two arms; an interventional arm receiving 300 mg/day of ALA (<em>n</em> = 25) and a non-interventional arm (n = 25). Initial assessments included HbA1c, urinary albumin excretion rate (UAER), malondialdehyde (MDA), and total antioxidant capacity (TAC). Baseline data was compared with 50 participants with T1D without DN and 50 healthy controls.</div></div><div><h3>Results</h3><div>T1D participants had significantly higher MDA and lower TAC levels compared to controls (<em>P</em> < 0.01). Within the T1D cohort, participants with DN showed significantly higher MDA and lower TAC levels (<em>P</em> < 0.01). MDA positively correlated with triglycerides (<em>r</em> = 0.53), UAER (<em>r</em> = 0.70), and HbA1c (r = 0.5) (<em>p</em> < 0.01), while TAC negatively correlated triglycerides (<em>r</em> = −0.41), UAER (<em>r</em> = −0.88), and HbA1c (<em>r</em> = −0.64) (<em>p</em> < 0.01). After 3 months of ALA supplementation, significant reductions in HbA1c, UAER, and MDA were observed, along with an increase in TAC (<em>P</em> < 0.01).</div></div><div><h3>Conclusion</h3><div>The study demonstrates that 3 months of ALA supplementation effectively reduced oxidative stress and UAER, demonstrating a potential role in protecting renal tissue from diabetes-induced oxidative damage.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109201"},"PeriodicalIF":3.1,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452046","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 : 2025-10-18DOI: 10.1016/j.jdiacomp.2025.109204
Emily Moroney , Monika A. Niewczas , Elif I. Ekinci , Richard J. MacIsaac
Multiple biomarkers have been associated with Diabetic Kidney Disease (DKD) progression and its associated exaggerated risk for cardiovascular events and mortality. Chronic inflammation plays an important role in the progression of DKD. Tumour Necrosis Factor alpha (TNF-α) is a central proinflammatory cytokine that binds to its soluble receptor (sTNFR) and has been implicated in the pathogenesis of DKD. sTNFRs are a family of membrane proteins that regulate gene expression and activate cell death pathways. They are involved in the immune system and can bind to cytokines related to TNF. Higher levels of the type 1 (sTNFR1) and type 2 (sTNFR2) receptor have consistently been associated with progressive DKD, notably rapid GFR decline and progression to kidney failure. They offer enhanced risk prediction for progressive DKD over and above established risk markers. Higher levels of sTNFR1 and sTNFR2 also predict incident cardiovascular disease and mortality in people with diabetes. Further studies are required to define the temporal relationship between changes in circulating sTNFR levels and progression of kidney function loss. The influence of medications with kidney protective effects on sTNFR levels also requires further investigation.
{"title":"Soluble tumor necrosis factor receptors (sTNFRs) as biomarkers for diabetic kidney disease","authors":"Emily Moroney , Monika A. Niewczas , Elif I. Ekinci , Richard J. MacIsaac","doi":"10.1016/j.jdiacomp.2025.109204","DOIUrl":"10.1016/j.jdiacomp.2025.109204","url":null,"abstract":"<div><div>Multiple biomarkers have been associated with Diabetic Kidney Disease (DKD) progression and its associated exaggerated risk for cardiovascular events and mortality. Chronic inflammation plays an important role in the progression of DKD. Tumour Necrosis Factor alpha (TNF-α) is a central proinflammatory cytokine that binds to its soluble receptor (sTNFR) and has been implicated in the pathogenesis of DKD. sTNFRs are a family of membrane proteins that regulate gene expression and activate cell death pathways. They are involved in the immune system and can bind to cytokines related to TNF. Higher levels of the type 1 (sTNFR1) and type 2 (sTNFR2) receptor have consistently been associated with progressive DKD, notably rapid GFR decline and progression to kidney failure. They offer enhanced risk prediction for progressive DKD over and above established risk markers. Higher levels of sTNFR1 and sTNFR2 also predict incident cardiovascular disease and mortality in people with diabetes. Further studies are required to define the temporal relationship between changes in circulating sTNFR levels and progression of kidney function loss. The influence of medications with kidney protective effects on sTNFR levels also requires further investigation.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"40 1","pages":"Article 109204"},"PeriodicalIF":3.1,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420257","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 : 2025-10-17DOI: 10.1016/S1056-8727(25)00239-9
{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00239-9","DOIUrl":"10.1016/S1056-8727(25)00239-9","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 11","pages":"Article 109186"},"PeriodicalIF":3.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320687","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 : 2025-10-17DOI: 10.1016/j.jdiacomp.2025.109200
J.M. Zubiria , E. Molina , E. Toledo , L. Forga , J. Hermida
Aims/hypothesis
The role of matrix metalloproteinase-10 (MMP-10) in the development of severe complications in patients with type 1 diabetes is not fully understood. The hypothesis is that elevated MMP-10 levels are associated with increased risk of severe complications and that genetic variants leading to reduced or non-functional MMP-10 may confer cardiovascular protection.
Methods
195 patients with type 1 diabetes were recruited between 2007 and 2010. Serum MMP-10 concentrations were measured at baseline, and participants were prospectively followed until 2020. The association between baseline MMP-10 levels and a composite endpoint of severe complications of diabetes was analysed. In addition, genetic analysis of the MMP10 gene was performed to identify mutations that can result in a non-functional MMP-10 and lead to cardiovascular protection.
Results
Participants in the highest quartile of MMP-10 levels had a threefold higher risk of reaching the composite endpoint compared to those in the lowest quartile (p = 0.038). Moreover, there was a common polymorphism rs17860955 (minor allele frequency: 12 %) that lead to a non-functional MMP-10. These variant carriers showed significantly lower MMP-10 concentration (457.8 ± 309.9 pg/ml vs 942.1 ± 519.6 pg/ml; p < 0.0001) and non-significantly lower composite endpoint events.
Conclusions
Low MMP-10 concentration is associated to protection against severe vascular complications in patients with type 1 diabetes. There is a frequent polymorphism (rs17860955) that leads to lower MMP-10 levels and may offer a degree of cardiovascular protection.
目的/假设：基质金属蛋白酶-10 （MMP-10）在1型糖尿病患者严重并发症发生中的作用尚不完全清楚。假设MMP-10水平升高与严重并发症的风险增加有关，基因变异导致MMP-10减少或无功能可能赋予心血管保护作用。方法：在2007 - 2010年间招募195例1型糖尿病患者。在基线时测量血清MMP-10浓度，并对参与者进行前瞻性随访至2020年。分析了基线MMP-10水平与糖尿病严重并发症的复合终点之间的关系。此外，对MMP10基因进行了遗传分析，以确定可能导致无功能MMP-10并导致心血管保护的突变。结果：MMP-10水平最高四分位数的参与者达到复合终点的风险是最低四分位数的参与者的三倍（p = 0.038）。此外，存在一个共同的多态性rs17860955（次要等位基因频率：12%），导致MMP-10无功能。这些变异携带者的MMP-10浓度显著降低（457.8±309.9 pg/ml vs 942.1±519.6 pg/ml）。结论：低MMP-10浓度与1型糖尿病患者严重血管并发症的预防有关。有一个常见的多态性（rs17860955）导致较低的MMP-10水平，并可能提供一定程度的心血管保护。
{"title":"Association of matrix metalloproteinase-10 levels and genetic variant rs17860955 with severe vascular complications in patients with type 1 diabetes: prospective cohort","authors":"J.M. Zubiria , E. Molina , E. Toledo , L. Forga , J. Hermida","doi":"10.1016/j.jdiacomp.2025.109200","DOIUrl":"10.1016/j.jdiacomp.2025.109200","url":null,"abstract":"<div><h3>Aims/hypothesis</h3><div>The role of matrix metalloproteinase-10 (MMP-10) in the development of severe complications in patients with type 1 diabetes is not fully understood. The hypothesis is that elevated MMP-10 levels are associated with increased risk of severe complications and that genetic variants leading to reduced or non-functional MMP-10 may confer cardiovascular protection.</div></div><div><h3>Methods</h3><div>195 patients with type 1 diabetes were recruited between 2007 and 2010. Serum MMP-10 concentrations were measured at baseline, and participants were prospectively followed until 2020. The association between baseline MMP-10 levels and a composite endpoint of severe complications of diabetes was analysed. In addition, genetic analysis of the <em>MMP10</em> gene was performed to identify mutations that can result in a non-functional MMP-10 and lead to cardiovascular protection.</div></div><div><h3>Results</h3><div>Participants in the highest quartile of MMP-10 levels had a threefold higher risk of reaching the composite endpoint compared to those in the lowest quartile (<em>p</em> = 0.038). Moreover, there was a common polymorphism rs17860955 (minor allele frequency: 12 %) that lead to a non-functional MMP-10. These variant carriers showed significantly lower MMP-10 concentration (457.8 ± 309.9 pg/ml vs 942.1 ± 519.6 pg/ml; <em>p</em> < 0.0001) and non-significantly lower composite endpoint events.</div></div><div><h3>Conclusions</h3><div>Low MMP-10 concentration is associated to protection against severe vascular complications in patients with type 1 diabetes. There is a frequent polymorphism (rs17860955) that leads to lower MMP-10 levels and may offer a degree of cardiovascular protection.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109200"},"PeriodicalIF":3.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345449","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 : 2025-10-17DOI: 10.1016/j.jdiacomp.2025.109198
Adriana Wisniewski , Justin DeMonte , Angelica Cristello Sarteau , Angela Fruik , Ruth S. Weinstock , Anna R. Kahkoska
Objective
Characterize diabetes distress (DD) in older adults with type 1 diabetes (T1D) and explore associations with individual-level characteristics.
Research design & methods
Adults ≥65 years with T1D (n = 337; mean 70.7 years) were recruited from the T1D Exchange (08/27/2024–11/05/2024) to complete an electronic survey, including the Type 1 Diabetes Distress Assessment System. Univariable linear regressions were used to assess cross-sectional associations between DD and self-reported sociodemographic, clinical, and diabetes-related variables. Select variables were explored further using bar graphs of DD core and source scores.
Results
The median (IQR) DD core score was 1.75 (1.375–2.5), and 36.5 % of respondents had a clinically significant DD core score. DD was positively associated with being female (β = 0.37; 95 % CI: 0.20–0.55), higher HbA1c (β = 0.32; 95 % CI: 0.21–0.43), and an emergency room (ER) visit in the past year (β = 0.33; 95 % CI: 0.12–0.53). DD was negatively associated with longer T1D duration (β = −0.01; 95 % CI: −0.02 to −0.01). The most prominent sources of DD were financial, management, and complication worries, and the least prominent were interpersonal, shame, and resources.
Conclusions
In addition to known correlates of DD among individuals with T1D (e.g., HbA1c), this study revealed novel correlates of DD among older adults, including older age at diagnosis, at least one ER visit within the last 12 months, and shorter T1D duration. Limitations include self-reported variables, the cross-sectional nature, and a relatively homogeneous sample by race, high prevalence of technology use, and HbA1c levels largely at goal.
{"title":"Levels of diabetes distress and its sources among older adults with type 1 diabetes and relationships to diabetes duration","authors":"Adriana Wisniewski , Justin DeMonte , Angelica Cristello Sarteau , Angela Fruik , Ruth S. Weinstock , Anna R. Kahkoska","doi":"10.1016/j.jdiacomp.2025.109198","DOIUrl":"10.1016/j.jdiacomp.2025.109198","url":null,"abstract":"<div><h3>Objective</h3><div>Characterize diabetes distress (DD) in older adults with type 1 diabetes (T1D) and explore associations with individual-level characteristics.</div></div><div><h3>Research design & methods</h3><div>Adults ≥65 years with T1D (<em>n</em> = 337; mean 70.7 years) were recruited from the T1D Exchange (08/27/2024–11/05/2024) to complete an electronic survey, including the Type 1 Diabetes Distress Assessment System. Univariable linear regressions were used to assess cross-sectional associations between DD and self-reported sociodemographic, clinical, and diabetes-related variables. Select variables were explored further using bar graphs of DD core and source scores.</div></div><div><h3>Results</h3><div>The median (IQR) DD core score was 1.75 (1.375–2.5), and 36.5 % of respondents had a clinically significant DD core score. DD was positively associated with being female (β = 0.37; 95 % CI: 0.20–0.55), higher HbA1c (β = 0.32; 95 % CI: 0.21–0.43), and an emergency room (ER) visit in the past year (β = 0.33; 95 % CI: 0.12–0.53). DD was negatively associated with longer T1D duration (β = −0.01; 95 % CI: −0.02 to −0.01). The most prominent sources of DD were financial, management, and complication worries, and the least prominent were interpersonal, shame, and resources.</div></div><div><h3>Conclusions</h3><div>In addition to known correlates of DD among individuals with T1D (e.g., HbA1c), this study revealed novel correlates of DD among older adults, including older age at diagnosis, at least one ER visit within the last 12 months, and shorter T1D duration. Limitations include self-reported variables, the cross-sectional nature, and a relatively homogeneous sample by race, high prevalence of technology use, and HbA1c levels largely at goal.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109198"},"PeriodicalIF":3.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345459","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 : 2025-10-15DOI: 10.1016/j.jdiacomp.2025.109196
Hulya Yilmaz Aydogan , Deniz Kanca Demirci , Nurdan Gul , Fatih Yanar , Sukran Poyrazoglu , Seda Gulec Yilmaz , Mete Bora Tuzuner , Turgay Isbir , Oguz Ozturk , Ilhan Satman
Background
The distribution of intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions specific to diabetes types and changes under dyslipidemia conditions have been well characterised. Research into the distribution of lipoprotein subfractions in Maturity-Onset Diabetes of the Young (MODY) has hitherto been confined to certain subtypes, with gender-based differences remaining to be elucidated. The objective of this study was to comparatively evaluate the distribution of lipoprotein subfractions according to gender in MODY, T2DM patients, and control groups.
Methods
Lipoprotein subfractions in 119 serum samples of the study groups were analyzed using the Lipoprint-System.
Results
The midbands of IDL (MID-A to C) in female MODY cases, and the HDL-small fraction in male MODY cases, were found to be lower compared to female and male T2DM cases, respectively. In the T2DM group, age was positively correlated with MID-C and MID-B in both genders, while it was negatively correlated with MID-A in female cases. ROC analysis demonstrated that the decrease in the MID-C fraction in female MODY subjects (AUC:0.809, p = 0.0001) and the decrease in the HDL-small fraction in male MODY subjects (AUC:0.818, p = 0.002) were significantly associated with the likelihood of MODY.
Conclusion
Given that a considerable proportion of MODY patients are frequently misdiagnosed as T2DM, low levels of MID-C and HDL-small fractions, both of which are triglyceride-rich, may have potential as a diagnostic value for female and male MODY patients, respectively.
背景：中密度脂蛋白（IDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）亚组分的分布已经很好地表征了糖尿病类型和血脂异常条件下的变化。迄今为止，对成熟型糖尿病（MODY）中脂蛋白亚组分分布的研究仅限于某些亚型，性别差异仍有待阐明。本研究的目的是比较评价MODY、T2DM和对照组中不同性别的脂蛋白亚组分分布。方法采用脂印系统对119份研究组血清中的脂蛋白亚组分进行分析。结果女性MODY患者的IDL中带（MID-A ~ C）和男性MODY患者的HDL-small比例分别低于女性和男性T2DM患者。在T2DM组中，年龄与男女MID-C、MID-B呈正相关，与女性MID-A呈负相关。ROC分析显示，女性MODY受试者中MID-C分数的降低（AUC:0.809, p = 0.0001）和男性MODY受试者中hdl -小分数的降低（AUC:0.818, p = 0.002）与MODY发生的可能性显著相关。鉴于相当比例的MODY患者经常被误诊为T2DM，低水平的中c和高密度脂蛋白小分数（两者都富含甘油三酯）可能分别对女性和男性MODY患者具有潜在的诊断价值。
{"title":"Gender differences in the distribution of IDL, LDL, and HDL lipoprotein subfractions in MODY compared to type 2 diabetes: Data from the MODY-Ist study","authors":"Hulya Yilmaz Aydogan , Deniz Kanca Demirci , Nurdan Gul , Fatih Yanar , Sukran Poyrazoglu , Seda Gulec Yilmaz , Mete Bora Tuzuner , Turgay Isbir , Oguz Ozturk , Ilhan Satman","doi":"10.1016/j.jdiacomp.2025.109196","DOIUrl":"10.1016/j.jdiacomp.2025.109196","url":null,"abstract":"<div><h3>Background</h3><div>The distribution of intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions specific to diabetes types and changes under dyslipidemia conditions have been well characterised. Research into the distribution of lipoprotein subfractions in Maturity-Onset Diabetes of the Young (MODY) has hitherto been confined to certain subtypes, with gender-based differences remaining to be elucidated. The objective of this study was to comparatively evaluate the distribution of lipoprotein subfractions according to gender in MODY, T2DM patients, and control groups.</div></div><div><h3>Methods</h3><div>Lipoprotein subfractions in 119 serum samples of the study groups were analyzed using the Lipoprint-System.</div></div><div><h3>Results</h3><div>The midbands of IDL (MID-A to C) in female MODY cases, and the HDL-small fraction in male MODY cases, were found to be lower compared to female and male T2DM cases, respectively. In the T2DM group, age was positively correlated with MID-C and MID-B in both genders, while it was negatively correlated with MID-A in female cases. ROC analysis demonstrated that the decrease in the MID-C fraction in female MODY subjects (AUC:0.809, <em>p</em> = 0.0001) and the decrease in the HDL-small fraction in male MODY subjects (AUC:0.818, <em>p</em> = 0.002) were significantly associated with the likelihood of MODY.</div></div><div><h3>Conclusion</h3><div>Given that a considerable proportion of MODY patients are frequently misdiagnosed as T2DM, low levels of MID-C and HDL-small fractions, both of which are triglyceride-rich, may have potential as a diagnostic value for female and male MODY patients, respectively.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109196"},"PeriodicalIF":3.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417943","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 : 2025-10-15DOI: 10.1016/j.jdiacomp.2025.109193
A.H. Abdelhafiz , I. Siqueira , A.J. Sinclair
Frailty is a metabolically heterogeneous condition and therefore, frail older people with diabetes are metabolically diverse. Diversity is caused by the varying degrees of insulin resistance, determined by the variability in muscle mass/visceral fat ratio and the overall body weight. This creates a frailty spectrum with sarcopenic/obese at one end to malnourished anorexic individuals at the other end. The sarcopenic obese are likely to have increased insulin resistance and progression of the metabolic syndrome. On the other hand, the anorexic malnourished are likely to have decreased insulin resistance due to significant weight loss and regression of the metabolic syndrome. The current evidence showed benefits of SGLT-2 inhibitors and GLP-1RA in frail older people with diabetes, and these benefits increased with increasing frailty. However, the majority of the population who benefited from this therapy were either overweight or obese. There is no evidence of benefits of such therapy in the anorexic malnourished end of the frailty spectrum such as people residents in care homes who were likely excluded from clinical trials. As the sarcopenic obese frail individuals are likely to have high burden of atherosclerotic vascular disease, we suggest that triple therapy of metformin, SGLT-2 inhibitors and GLP-1RA to be initiated as first line therapy in this group of patients if tolerated. On the other hand, this therapy is better avoided in the malnourished frail individuals due to significant weight loss, high risk of adverse events and, due to regression of the metabolic syndrome, the cardiovascular benefits are uncertain.
{"title":"Criteria of frail older people with type 2 diabetes who are suitable for SGLT-2 inhibitors and GLP-1RA therapy","authors":"A.H. Abdelhafiz , I. Siqueira , A.J. Sinclair","doi":"10.1016/j.jdiacomp.2025.109193","DOIUrl":"10.1016/j.jdiacomp.2025.109193","url":null,"abstract":"<div><div>Frailty is a metabolically heterogeneous condition and therefore, frail older people with diabetes are metabolically diverse. Diversity is caused by the varying degrees of insulin resistance, determined by the variability in muscle mass/visceral fat ratio and the overall body weight. This creates a frailty spectrum with sarcopenic/obese at one end to malnourished anorexic individuals at the other end. The sarcopenic obese are likely to have increased insulin resistance and progression of the metabolic syndrome. On the other hand, the anorexic malnourished are likely to have decreased insulin resistance due to significant weight loss and regression of the metabolic syndrome. The current evidence showed benefits of SGLT-2 inhibitors and GLP-1RA in frail older people with diabetes, and these benefits increased with increasing frailty. However, the majority of the population who benefited from this therapy were either overweight or obese. There is no evidence of benefits of such therapy in the anorexic malnourished end of the frailty spectrum such as people residents in care homes who were likely excluded from clinical trials. As the sarcopenic obese frail individuals are likely to have high burden of atherosclerotic vascular disease, we suggest that triple therapy of metformin, SGLT-2 inhibitors and GLP-1RA to be initiated as first line therapy in this group of patients if tolerated. On the other hand, this therapy is better avoided in the malnourished frail individuals due to significant weight loss, high risk of adverse events and, due to regression of the metabolic syndrome, the cardiovascular benefits are uncertain.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109193"},"PeriodicalIF":3.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345451","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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