Journal of Diabetes Investigation最新文献

Objective: Research indicates that LINC00707 is abnormally expressed in patients suffering from diabetic kidney disease (DKD). Nevertheless, the precise role of LINC00707 in the context of DKD remains enigmatic and warrants further investigation.

Methods: Initially, RT-qPCR was employed to assess the expression levels of LINC00707 in patients with DKD. Subsequently, we cultured glomerular podocytes under high-glucose conditions. The effects of LINC00707 on cell proliferation, apoptosis, podocyte functionality (Podocin, Nephrin, and CD2AP), oxidative stress (MDA and SOD), and inflammatory responses (IL-1β, IL-6, and TNF-α) were evaluated using CCK-8, flow cytometry, RT-qPCR, and ELISA assays. Finally, we co-regulated LINC00707 alongside its downstream targets to elucidate the molecular mechanisms by which LINC00707 influences podocyte injury.

Results: LINC00707 is abnormally upregulated in DKD patients. Furthermore, a notable inverse correlation has been observed between LINC00707 levels and renal function in these patients. Upon downregulating LINC00707, we observed an increase in cellular proliferative activity, alongside elevated levels of Podocin, Nephrin, and CD2AP. Concurrently, the reduction of LINC00707 was associated with decreased levels of MDA, as well as proinflammatory cytokines. Significantly, the inhibition of miR-223-3p was found to reverse these observed effects. Further investigation revealed that miR-223-3p directly targets FK506-binding protein 5 (FKBP5).

Conclusions: Inhibition of LINC00707 may reduce podocyte damage during hyperglycemia by targeting miR-223-3p/FKBP5.

Objectives: Type 1 diabetes mellitus (T1DM) is a significant global health issue, particularly due to its association with microvascular complications such as diabetic peripheral neuropathy (DPN). Sensory nerves in the lower extremities are primarily affected by DPN, with the sural nerve being particularly impacted. The conventional method for diagnosing DPN involves evaluating four motor and four sensory nerves in the upper and lower extremities. Motor tests use dual-point high-intensity stimulation to elicit a compound muscle action potential, while sensory tests apply a single, lower-intensity stimulus to assess depolarized nerve fibers. The aim of this study was to define the efficacy of using a single sural nerve response for the diagnosis of DPN in pediatric T1DM patients compared to the conventional method.

Methods: This retrospective study analyzed data from 242 patients, including 204 with T1DM and 38 controls. For T1DM patients, we evaluated risk factors for DPN, including age, gender, hemoglobin A1c levels, lipid parameters, and body mass index. Nerve conduction studies were evaluated in both groups.

Results: The examination of a single sural nerve achieved a sensitivity of 83.3% and a specificity of 97.2% in diagnosing DPN. Multivariate logistic regression analysis identified HbA1c level as the only significant predictor of DPN. Comparison of sural nerve responses between non-neuropathic T1DM patients and the control group indicated pre-electrophysiological nerve abnormalities within the T1DM cohort.

Conclusions: Evaluation of a single sural nerve response in pediatric T1DM patients can replace conventional nerve studies. The study supports the use of point-of-care devices for DPN detection, potentially simplifying and enhancing clinical practice.

Type 2 diabetes mellitus (T2DM) is a major global public health challenge driven by a complex interplay of genetic, environmental, and social factors. This review highlights the effects of social determinants of health (SDOH) on T2DM in Asia, where rapid urbanization, worsening air pollution, and distinct socioeconomic structures uniquely influence disease outcomes. Key SDOH domains, socioeconomic status (education, income, and occupation), physical environment, food environment, healthcare access, and social context, were analyzed for their associations with T2DM prevalence, progression, and management. Among these, environmental and lifestyle shifts have emerged as particularly influential factors in Asia. Air pollution, particularly fine particulate matter, has been increasingly linked to insulin resistance and diabetes risk in Asian populations. Additionally, rapid urbanization and changing food environments contribute to rising T2DM incidence through shifts in lifestyle and dietary patterns. Across the diverse healthcare systems of Asian countries, primary care remains a universally critical component in addressing T2DM issues. Additionally, social capital and cohesion serve as protective factors, whereas social isolation heightens vulnerabilities. These insights underscore the importance of addressing SDOH in public health strategies to combat T2DM in Asia. Future research should prioritize longitudinal studies and culturally tailored interventions to reduce the region's diabetes burden.

Aim: No studies have specifically examined the effects of finerenone in treating type 2 diabetes patients with chronic kidney disease (CKD) and microalbuminuria. This study aimed to evaluate the effectiveness of finerenone in this group of patients.

Methods: This retrospective real-world study (ChiCTR2400087169) included type 2 diabetes outpatients with CKD from the Peking University First Hospital between March 2023 and March 2024. All patients in this study had a urinary albumin-to-creatinine ratio (UACR) of 30-299 mg/g. The effects of finerenone were assessed by comparing UACR, HbA1c, creatinine, serum potassium, eGFR, and blood pressure at baseline and after treatment.

Results: Sixty-four patients (39 males and 25 females), with a median age of 65.75 years and a median duration of T2DM of 15.21 years, were included. The baseline median UACR was 100.50 mg/g, significantly decreased to 61.27 mg/g (P < 0.001) at 3 months and 62.49 mg/g (P < 0.001) at 6 months after treatment. None of the other parameters differed significantly. Finerenone alone or in combination with ABS inhibitors, SGLT2 inhibitors, or GLP-1 agonists did not result in significant differences in UACR reduction. Patients with a >30% UACR decrease had significantly higher baseline systolic blood pressure (SBP) than those with a ≤30% decrease (P < 0.05). Furthermore, baseline SBP significantly decreased after 6 months of treatment in patients with a >30% UACR reduction (P < 0.05).

Conclusions: Finerenone is effective in treating type 2 diabetes with CKD and microalbuminuria. Improved SBP control leads to a greater UACR reduction.

Recent updates on the efficacy of continuous glucose monitoring (CGM) and a critical examination of the current challenges in its implementation were summarized. The barriers to widespread adoption of this technology should be addressed, considering the impact of different cultural contexts. The strategies to overcome these obstacles and the benefits of CGM for future glucose management will be discussed.

Background: Food insecurity (FIS) affects around 25% of Bangladesh's population, and data from developed nations report higher FIS rates among individuals with type 2 diabetes (T2D), potentially worsening glycemic control. The importance of FIS to T2D has not been studied in developing countries such as Bangladesh, with substantial disparities in healthcare access, especially between rural and urban areas. We evaluated the relationships between food insecurity and glycemic control in the context of area of residence among individuals with T2D in Bangladesh.

Methods: A total of 849 individuals with T2D attending diabetes clinics in four districts of Bangladesh completed a validated questionnaire to assess the FIS (a score ≥ 3 is indicative of FIS), which was compared with their sociodemographic and biochemical data. Two-way anova and multiple linear and binary logistic regression analyses were performed.

Results: Both HbA1c levels (10.8% vs 9.5, P < 0.001) and the prevalence of FIS (45.8% vs 31.4%, P < 0.001) were higher in rural areas. According to two-way anova (0.87-1.78% mean difference, P < 0.05) and multiple linear regression model (β = 1.4, P < 0.001), HbA1c levels were also higher among rural than urban dwellers, irrespective of their FIS status. Rural dwellers were also more than twice as likely to have suboptimal glycemic control (HbA1c ≥7%; AOR: 2.26 (1.35-3.97), P < 0.05), irrespective of their food security status (AOR: 1.19 (0.78-1.84, P > 0.05)).

Conclusions: In Bangladesh, rural residence is associated with poor glycemic control, irrespective of food security status, and thus is an important social determinant of diabetes care that warrants further exploration.

Objective: This study aims to analyze the disease burden of ischemic heart disease (IHD) caused by hyperglycemia and its changing trend, and to construct a visualization platform for disease burden and forecast trends on the Shiny platform.

Materials and methods: Using data from the 2021 Global Burden of Disease Study, we analyzed deaths and disability-adjusted life years (DALYs) due to IHD triggered by hyperglycemia, with detailed analysis by region, gender, and age. The age-period-cohort model was used to assess the impact of age, cohort, and period on age-standardized disease rates across different Socio-Demographic Index (SDI) regions, and decomposition analysis was employed to disentangle the contributions of population, aging, and epidemiological changes.

Results: In 2021, approximately 14-15% of IHD's DALYs and deaths were attributed to high fasting plasma glucose (HFPG), with a nonsignificant decrease in the annual average percentage change of DALYs. In middle, low-middle, and low SDI regions, the age-standardized mortality rates caused by HFPG are increasing, particularly among males. In high-middle and high SDI regions, the effects of aging and epidemiological changes surpass population growth, whereas in low SDI regions, population growth is the main factor. By 2050, the global Age-Standardized Mortality Rate of IHD attributed to HFPG is projected to reach 16.96. More data can be accessed by visiting the disease burden visualization platform.

Conclusion: Global HFPG-induced IHD health presents significant imbalances. In low SDI regions with larger populations and more unbalanced healthcare distribution, there is a need to strengthen the construction of medical levels.

Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real-World with GLP-1RAs) study characterized demographics, clinical characteristics, and medication use in treatment-intensified (add-on to metformin) adults with type 2 diabetes (T2D) in Thailand.

Methods: A retrospective cross-sectional study of data from medical records (Jul 26, 2013, to Dec 31, 2017) was descriptively summarized for overall population and subgroups defined by glucose-lowering agent (GLA) classes.

Results: Data from 1,000 adults were collected in reverse chronological order. At baseline, the mean (SD) age was 60 (12) years, HbA_1c was 8.0%, and the median (IQR) T2D duration was 1.0 (0.2-2.4) years. Patients taking SGLT2-is (sodium glucose cotransporter-2 inhibitors) had a longer T2D duration (1.8 years, 0.8-3.2), GLP-1RAs (glucagon-like peptide-1 receptor agonists) had a higher body mass index of 32.0 (8.84) kg/m², and insulin subgroup had a higher HbA_1c 8.5% (7.5-10.1). The utilization of GLP-1 RAs/SGLT-2is was low (1.5% and 6%, respectively). Among the subgroups, most patients in the GLP-1RA (80.0%) and insulin subgroup (81.3%) receiving 3/≥4 GLAs. The most frequently prescribed GLAs post-metformin were sulfonylureas (45.2%) and dipeptidyl peptidase-4 inhibitors (39.4%). Overall, 90% received ≥1 cardiovascular (CV) medication; lipid-lowering agents (78%) were the most prescribed.

Conclusions: These results indicate low utilization of GLAs with CV benefits, attributed to a lack of CV benefit data during the study period and partial reimbursement implementation. Future studies must identify barriers to adoption and estimate the usage of these GLAs with CV benefits as more evidence becomes available on positive CV outcomes to improve patient care in Thailand.

Neonatal diabetes mellitus (NDM) is a monogenic condition diagnosed <6 months of age with >40 genetic causes. International guidelines recommend referral for genetic testing immediately after diagnosis since the genetic result guides clinical management. We used next-generation sequencing to identify a homozygous pathogenic variant, p.(Arg244*), in COQ9 in 2 individuals referred for NDM testing. Both had insulin-treated hyperglycemia, severe structural brain defects, dysmorphic features, and lactic acidosis. Recessive loss-of-function variants in COQ9 cause Coenzyme Q10 deficiency-5, a multi-system mitochondrial disease, with 7 cases reported. Neonatal hyperglycemia has not been reported in any of these cases but has been described for two other Coenzyme Q10 disorders caused by variants in COQ2 and COQ4. Our report shows that individuals with COQ9-related disease can present with neonatal hyperglycemia, expanding the clinical spectrum of this disorder. We recommend the inclusion of COQ9, as well as COQ2 and COQ4, to gene panels used for NDM testing.