Journal of Diabetes Investigation最新文献

Aims/introduction: Diabetes mellitus (DM) increases postoperative risks and may worsen physical function through muscle loss. Patients undergoing malignancies surgery are aging, and age-related declines in physical function, particularly sarcopenia, also adversely affects outcomes. As DM and physical decline are interrelated, we aimed to examine how they impact outcomes in older patients undergoing gastrointestinal cancer surgery.

Materials and methods: This single-center retrospective cohort study included 1,063 older patients ≥65 years who underwent preoperative evaluation for gastrointestinal cancer between 2012 and 2019. We stratified patients based on current DM and physical function assessed by grip strength. The main outcome was postoperative survival. Cox proportional hazards models examined associated factors.

Results: After exclusions, 655 without DM (non-DM group) and 257 patients with DM (DM group) were analyzed (mean age: 79.1 ± 4.1 years, 66.8% male). Compared with the non-DM group, the DM group had higher body mass index (21.5 vs 22.6 kg/m²), higher cardiovascular disease prevalence (26.9 vs 41.2%), and more frequent weak grip strength (53.9 vs 65.8%). Postoperative survival analysis showed no significant difference between the two groups (P = 0.651). Multivariate analysis showed current DM was not an independent risk factor, whereas grip strength remained significantly associated with poor outcomes (HR 0.97 95% CI 0.95-1.00), and no significant interactions were found (P = 0.656).

Conclusions: Current DM did not significantly affect postoperative outcomes; however, lower grip strength was an independent risk factor for poor outcomes. The prognostic impact of reduced physical function was consistent regardless of DM status.

Background: Reports suggested that diabetes could be a complication arising from COVID-19; however, the relationship between COVID-19 and the development of gestational diabetes mellitus (GDM) remains unclear.

Objectives: This study aimed to investigate the association between COVID-19 infections and the risk of incident GDM in pregnant women.

Methods: We analyzed data from Taiwan's National Health Insurance Research Database (NHIRD), which is linked to the Birth Reporting Database and the COVID-19 testing database between 2020 and 2022. A case-control study was conducted, matching pregnant women by age and region. We employed multivariable logistic regression, adjusting for matching factors and potential confounders. The findings were further validated through a sensitivity analysis using a cohort design with landmark analysis.

Results: The study included 134,375 pregnant women, comprising 26,875 GDM cases and 107,500 matched controls. After adjusting for covariates, we found no evidence supporting an association between prior COVID-19 infection and incident GDM (adjusted odds ratio [aOR] = 0.95, 95% confidence interval [CI] = 0.89-1.01). Notably, some evidence showed that receiving at least one COVID-19 vaccination was associated with a decreased risk of GDM (aOR = 0.90, 95% CI = 0.87-0.93). These results remained consistent in the sensitivity analysis.

Conclusion: Despite COVID-19 now being endemic with less virulent variants, ongoing vigilance regarding potential pregnancy-related impacts of SARS-CoV-2 is essential. It is also critical to promote vaccination among women of childbearing age, and further research is necessary to explore COVID-19-related complications during pregnancy.

We report long-term remission in a patient with type B insulin resistance achieved with a combination of immunotherapies. A 55-year-old Japanese man presented with nocturnal hypoglycemia and cytopenia. He also had postprandial hyperglycemia due to severe insulin resistance, which was difficult to manage using high-dose insulin and recombinant human insulin-like growth factor-1. Serological testing showed type B insulin resistance syndrome associated with systemic lupus erythematosus. Glucocorticoids and mycophenolate/azathioprine combination therapy were introduced, resulting in a prompt improvement in glycemic control. The patient has remained in clinical and serological remission for 8 years. Over the past year, he achieved euglycemia with azathioprine monotherapy, without the need for insulin or oral antiglycemic agents.

Introduction: Type 2 diabetes mellitus (T2DM) is a common public health problem in the world. Patients with T2DM patients are accompanied with the risk of cardiovascular disease. Clarification of the potential molecular mechanism underlying vascular complications in diabetes mellitus (DM) is crucial for avoiding cardiovascular disease. Fibroblast growth factor 11 (FGF11) is a member of FGF family which, as reported before, can play a causative role in vascular dysfunction in T2DM.

Materials & methods: Human microvascular endothelial cells (HMVECs) were treated with high glucose (HG) to simulate T2DM model. Functional assays were carried out to disclose the cell proliferation, apoptosis, migration and angiogenesis of HG-treated HMVECs. Several mechanical experiments including RNA pull down, luciferase reporter and RNA immunoprecipitation (RIP) determined the regulatory mechanism of FGF11 in HG-treated HMVECs.

Results: FGF11 displayed a low expression in HG-treated HMVECs. FGF11 overexpression inhibited proliferation, migration and angiogenesis of HMVECs while facilitated the cell apoptosis in under HG condition. Moreover, FGF11 was targeted by miR-520a-5p and miR-432-5p, and CTBP1-AS2 acted as a competing endogenous RNA to modulate FGF11 expression via sponging miR-520a-5p and miR-432-5p.

Conclusion: The axis of CTBP1-AS2/miR-520a-5p/miR-432-5p/FGF11 might be a potential target for T2DM treatment.

The goal of diabetes management is to achieve longevity and quality of life equivalent to those of people without diabetes, and for that, it is now deemed important to pay close attention not only to diabetic vascular complications but also to diabetic comorbidities, as is recommended by the Japan Diabetes Society. In this editorial, we focus on sarcopenia as an important diabetic comorbidity which is an aging-related phenomenon in skeletal muscle. Taking our recent report on a sarcopenia mouse model and other accumulated evidence into account, we propose the existence of a skeletal muscle-centered inter-tissue network that regulates frailty and systemic aging. Sarcopenia is deemed to be a state in which skeletal muscle serving as a protective mighty armor against frailty and systemic aging is lost, and it is vitally important to establish how to recover it and keep it in good shape, so that the goal of diabetes management can be achieved.