Pancreatic islet transplantation is a crucial treatment for managing type 1 diabetes (T1D) in clinical settings. However, the limited availability of human cadaveric islet donors and the need for ongoing administration of immunosuppressive agents post-transplantation hinder the widespread use of this treatment. Stem cell-derived islet organoids have emerged as an effective alternative to primary human islets. Nevertheless, implementing this cell replacement therapy still requires chronic immune suppression, which may result in life-long side effects. To address these challenges, innovations such as encapsulation devices, universal stem cells, and immunomodulatory strategies are being developed to mitigate immune rejection and prolong the function of the transplant. This review outlines the contemporary challenges in pancreatic β cell therapy, particularly immune rejection, and recent progress in immune-isolation devices, hypoimmunogenic stem cells, and immune regulation of transplants. A comprehensive evaluation of the advantages and limitations of these approaches will contribute to improved future clinical investigations. With these promising advancements, the application of pancreatic β cell therapy holds the potential to effectively treat T1D and benefit a larger population of T1D patients.
To investigate the associations of tea consumption with all-cause and cause-specific mortality among type 2 diabetes mellitus (T2DM) Chinese patients.
The present study included 15 718 participants from the Comprehensive Research on the Prevention and Control of Diabetes between 2013 and 2014 in Jiangsu, China. Information on tea consumption (including frequency, amount, and duration) was collected at baseline using interviewer-administered questionnaires. Death data were identified by linkage to the Death Certificate System. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
During a median follow-up of 9.77 (9.69, 9.82) years, 3046 deaths were documented, including 922 from cardiovascular disease (CVD) and 736 from cancer. Compared with nonconsumers, regular tea consumption (≥ 3 times/week, 1 cup/day, > 30 years) was associated with reduced all-cause mortality risk in T2DM, with HRs (95% CIs) of 0.82 (0.74, 0.91), 0.80 (0.72, 0.89), and 0.77 (0.68, 0.86). For cardiovascular mortality, the HRs (95% CIs) were 0.79 (0.65, 0.96), 0.72 (0.59, 0.89), and 0.75 (0.60, 0.93). The exposure-response relationship suggested that consuming 4 g/day may offer the most evident health benefits.
Among Chinese T2DM patients, higher tea frequency and amount intake were associated with lower risk of all-cause and CVD mortality. It is suggested that consuming 4 g/day of tea could potentially serve as an intervention target. These findings suggest that tea consumption can be a part of a healthy diet for T2DM patients.
To determine the value of lymphocyte subsets and granulocyte/monocyte surface markers in predicting the risk of post-acute pancreatitis diabetes (PPDM-A).
This study included 308 in patients with acute pancreatitis (AP). The markers of granulocytes and monocytes and lymphocyte subsets were detected by flow cytometry, and the fluorescence intensity, absolute count and percentage were obtained. Based on the occurrence of diabetes after AP, patients were divided into two groups: PPDM-A and PPNG-A (post-acute pancreatitis with normal glucose). Correlations between granulocyte and monocyte surface markers and lymphocyte subsets were analyzed. Binary logistic regression was used to analyze the potential influencing factors of PPDM-A.
Compared with patients with PPNG-A, patients with PPDM-A tend to be younger (p < 0.001) and have a higher proportion of fatty liver, recurrent pancreatitis, and hyperlipidemic pancreatitis. The results of linear regression showed that B% was negatively correlated with MFI of HLA-DR on monocytes (R2 = 0.145, p < 0.001), B% was positively correlated with CD10−NEUT% (R2 = 0.291, p < 0.001), and MFI of HLA-DR on monocytes was negatively correlated with CD10−NEUT% (R2 = 0.457, p < 0.001). Multivariate logistic regression analysis revealed that age, serous effusion, fatty liver, recurrent pancreatitis, and B% were independent risk factors for the occurrence of PPDM-A.
Our study has first confirmed the correlation between PPDM-A and lymphocyte subsets and CD10−NEUT%. Furthermore we indicated that age, fatty liver, serous effusion, recurrent AP, and B% were independent risk factors for PPDM-A. The mechanism of granulocyte and monocyte surface markers and B lymphocytes on PPDM-A is worthy of study. This would help clarify the pathogenesis of PPDM-A at the cellular level and potentially provide new strategies for immunotherapy and even disease prevention. [Correction added on 24 January 2025, after first online publication: the third subtitle in Abstract section has been changed to ‘Results’.]
Provide an evidence-based basis for the selection of cardiovascular benefit drugs in Type 2 diabetes mellitus (T2DM) patients with cardiovascular disease (CVD).
Conduct a comprehensive search of all relevant literature from PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials.gov from their establishment until December 13, 2023, and select randomized controlled trials (RCTs) that meet the pre-established inclusion and exclusion criteria. Use the Cochrane bias risk assessment tool to evaluate the quality of the included literature. Use R 4.3.2 software to conduct network meta-analysis for drug category comparison.
A total of 24 large-scale randomized controlled trials (RCTs) were included, including 19 intervention measures, and 172 803 patients participated in the study. The results of the network meta-analysis show that: GLP1RA (OR 0.89, 95% CI 0.81–0.97) and SGLT2i (OR 0.91, 95% CI 0.83–0.99) can reduce the occurrence of major adverse cardiovascular events (MACE), GLP1RA (OR 0.88, 95% CI 0.79–0.97) and SGLT2i (OR 0.89, 95% CI 0.81–0.99) reduced the risk of cardiovascular death. SGLT2i (OR 0.68, 95% CI 0.62–0.75) reduced the occurrence of hospitalization for heart failure, GLP1RA (OR 0.88, 95% CI 0.81–0.97) and SGLT2i (OR 0.89, 95% CI 0.80–0.97) reduced the occurrence of all-cause death.
In the comparison of new hypoglycemic drug classes, GLP1RA and SGLT2i reduced MACE, cardiovascular mortality and all-cause mortality in T2DM patients with CVD, with no significant difference in efficacy, and DPP4i was noninferior to placebo. Only GLP1RA reduced the risk of nonfatal stroke, and only SGLT2i reduced the risk of HHF.
Type 2 diabetes mellitus (T2DM) contributes to the heavy burden, but there lacks latest and comprehensive global research on the burden of T2DM attributable to low physical activity (LPA). This study aimed to quantify the global and regional burden of T2DM attributable to LPA from 1990 to 2021.
We utilized data including disability-adjusted life years (DALYs), mortality, age-standardized disability-adjusted life years (ASDR), and age-standardized mortality rates (ASMR) from the Global Burden of Disease (GBD) 2021. We assessed the burden across different ages, genders, and sociodemographic index (SDI). Joinpoint regression analysis was applied to estimated average annual percent change (AAPC).
Between 1990 and 2021, DALYs and mortality of T2DM attributable to LPA increased rapidly. There was an increase in the ASDR and ASMR, with AAPC of 1.09 (95% CI: 1.03–1.16) and 0.32 (95% CI: 0.2–0.43), which was increased faster in males. Low-middle SDI countries have the highest ASDR and highest ASMR. The global PAF for ASDR and ASMR in 2021 is 7.38% and 9.45%. A U-shaped drift pattern was observed in most SDI quintiles in APC model. Population growth is a major contributor to the burden of T2DM, especially in countries with low SDI. Epidemiological changes also play an important role in DALYs and mortality. A negative correlation existed between SDI and both ASMR and ASDR.
Between 1990 and 2021, there was a marked rise in the global burden of T2DM associated with LPA. The findings lay the groundwork for informed decision-making a public health and healthcare delivery.
To determine whether the use of herbal medicines combined with conventional treatment is more effective than conventional medication alone in improving clinical symptoms in patients with diabetic distal symmetric polyneuropathy (DSPN).
This multicenter, placebo-controlled, double-blind, randomized controlled clinical trial recruited patients from 6 clinical centers in mainland China. A total of 188 patients were randomly assigned in a 1:1 ratio to the treatment group (Tangbi Formula plus methylcobalamin) and the control group (placebo plus methylcobalamin). Subjects were reassessed after the 24-week intervention. The primary outcomes were differences in changes in clinical signs and symptoms and changes in the Michigan Diabetic Neuropathy Score (MDNS) between the two groups before and after treatment. Secondary outcomes were changes in nerve conduction velocity (NCV) and single clinical signs and symptoms as measured by the visual-analogue scale (VAS) and Toronto clinical scoring system (TCSS).
Compared with the placebo group, after 24 weeks of treatment, the MDNS score of TangBi Formula group was significantly reduced (p < 0.001). There were no significant changes in NCV results in either group before or after treatment. Compared with baseline, the difference in the change value of VAS score between the two groups after treatment was statistically significant (p = 0.031). A statistically significant difference in the change value of TCSS after treatment compared to baseline was found between the two groups (p = 0.033 at 12 weeks and p = 0.030 at 24 weeks). No severe adverse events due to study participation or study intervention were reported.
This trial demonstrated that combining Tangbi Formula with basal therapy can be safer and more effective in improving the symptoms of DSPN patients.
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