Journal of Diabetes最新文献

Diabetic wounds cannot undergo normal wound healing due to changes in the concentration of hyperglycemia in the body and soon evolve into chronic wounds causing amputation or even death of patients. Diabetic wounds directly affect the quality of patients and social medical management; thus researchers started to focus on skin transplantation technology. The acellular fish skin grafts (AFSGs) are derived from wild fish, which avoids the influence of human immune function and the spread of the virus through low-cost decellularization. AFSGs contain a large amount of collagen and omega-3 polyunsaturated fatty acids and they have an amazing effect on wound regeneration. However, after our search in major databases, we found that there were few research trials in this field, and only one was clinically approved. Therefore, we summarized the advantages of AFSGs and listed the problems faced in clinical use. The purpose of this paper is to enable researchers to better carry out original experiments at various stages.

The 21st annual World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease, held in Los Angeles, California on December 7–9, 2023, included 69 presentations spanning a myriad of aspects of diabetes and its complications, atherosclerosis, renal disease, liver disease, and novel therapeutic approaches. This second summary focuses on presentations at the meeting pertaining to obesity.

Philipp Scherer (Dallas, Texas) noted that, similarly to the importance of fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD), which may persist after steatosis has been treated and which underlies the development of cirrhosis, obesity is associated with increased localized fibrosis and disrupted angiogenesis in adipose tissue, mediated by low levels of adiponectin and increased production of leptin, steroid hormones, and inflammatory mediators.¹ Scherer highlighted the role of endotrophin, a cleavage product of collagen that may mediate fibrosis in the liver, kidneys, and heart. Development of agents to neutralize this peptide might have therapeutic benefits. He also showed studies suggesting that the greater clinical potency of tirzepatide than of the glucagon-like peptide (GLP)-1 receptor agonist (RA) semaglutide may be an effect of glucose-dependent insulinotropic polypeptide (GIP) receptor activation in increasing energy expenditure.

Richard Bergman (Los Angeles, California) discussed the use of the body mass index (BMI) in quantitating obesity, explaining that the measure derives from the work of Adolphe Quetelet, who developed the concept of the “Average Man” in the nineteenth century. He proposed use of an index based on the observation that weight varied in proportion to the square of height. During the twentieth century the term BMI was popularized by Ancel Keys, based on studies showing that the Quetelet index correlated with direct measurements of body fat. The BMI does not, however, give information about fat distribution, and Bergman suggested that it is not a good measure of body fat, giving no information about the mechanisms operative in a given individual. Measurement of skinfold thicknesses, the use of BMI in conjunction with waist circumference, underwater weighing, and the more recent body adiposity index (calculated as hip/height^1.48) have been proposed. Bergman reviewed his work in population studies with dual-energy X-ray absorptiometry measurement of fat mass. Analysis of a variety of possible relationships between sex, height, weight, and waist circumference led Bergman to propose a new measure, relative fat mass (RFM), calculated as: RFM = 64 – (20*Height/WC) + (12*sex), with sex = 0 in men and sex = 1 (women).^{2, 3} Bergman reviewed studies showing good prediction of risks of diabetes, heart failure, and coronary disease with this measure.

Samuel Klein (St. Louis, Missouri) discussed the complex relationships between BMI and cardiovascula

Clinical practice guidelines (CPGs) serve as pivotal frameworks for standardizing evidence-based diagnostic and therapeutic approaches, particularly in the management of diabetes and beyond.^{1, 2} However, the integrity of these guidelines can be compromised by conflicts of interest (COIs).^3-5 Given that current increasing attention from pharmaceutical companies to diabetologists^{6, 7} and large prevalence of diabetes and obesity, proper management of financial COIs is essential for trustworthy diabetes CPGs.¹ Despite the critical nature of this issue, no research has investigated these financial relationships in the Japanese context.

Using a publicly accessible database (https://yenfordocs.jp/) containing personal payments for lecturing, consulting, and manuscript drafting from all pharmaceutical companies affiliated with the Japan Pharmaceutical Manufacturers Association, this study examined personal payments made to all authors for Japanese Clinical Practice Guideline for Diabetes 2019 (JCPGD) developed by the Japan Diabetes Society in 2019.⁸ Descriptive analysis was performed on the payment data extracted from the database between 2016 and 2020.

Among all 135 JCPGD authors, 129 (95.6%) received at least one personal payment for lecturing, consulting, and manuscript drafting from the pharmaceutical companies over the 5 years (Table 1). A total of 19 755 payments, amounting to $23 130 423, were made to the JCPGD authors by the pharmaceutical companies. The median payments per author were $89 955 (interquartile range: $7954–$258 527). More than 74.1% (100 authors), 60.7% (82 authors), and 47.4% (64 authors) received more than $10 000, $50 000, and $100 000 in total payments over the 5 years, respectively. The JCPGD chairperson received $207 889 before the JCPGD publication (2016–2018).

Of 135 authors, 80 (59.3%) self-declared financial COIs with companies between 2016 and 2018. However, the Japan Diabetes Society allowed the CPG authors to omit declaring financial COIs below a certain monetary threshold (eg, 500 000 Japanese yen, equivalent to $4683, or more per year per company for lecturing, honoraria, and drafting compensations). Consequently, 55 (40.7%) authors declared no COIs between 2016 and 2018, although 87.2% (48 out of 55) of these authors received at least some personal payments during the declaration period (2016–2018).

This study examined the size and prevalence of financial conflicts of interest among authors of the JCPGD 2019. Surprisingly, more than 95% of the JCPGD authors received more than $23.1 million in personal payments from pharmaceutical companies. Furthermore, the chairpersons received considerable amounts of personal payments during the guideline development period. The high percentage of JCPGD authors with financial COIs, the chairpersons' receipt of personal payments, and lim