Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

Effectiveness of alpha lipoic acid supplementation on biochemical, clinical, and inflammatory parameters in patients with diabetic polyneuropathy: A systematic review and meta-analysis 补充α硫辛酸对糖尿病多发神经病变患者生化、临床和炎症参数的影响：一项系统综述和荟萃分析

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-02-01 DOI: 10.1016/j.dsx.2026.103374

Ayline Vergara Salinas , Trinidad Meneses Caroca , Fernanda Peña Santibáñez , Javiera Rojo González , Michelle López-Chaparro , Marisol Barahona-Vásquez , Jessica Paola Loaiza-Giraldo , Consuelo Gómez-Valdovinos , Juan José Valenzuela-Fuenzalida , Pablo Nova-Baeza , Mathias Orellana-Donoso , Alejandro Bruna-Mejias , Gloria Cifuentes-Suazo , Gustavo Oyanedel-Amaro , Juan Sanchis-Gimeno , Guinevere Granite , Felipe Araya-Quintanilla

Introduction

In this article, we perform a systematic review and meta-analysis evaluating the effects of alpha-lipoic acid (ALA) supplementation on biochemical, clinical, inflammatory, and functional parameters in patients with diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). A total of 15 articles were included, of which 12 were analyzed for outcomes. DPN is a chronic complication of Diabetes Mellitus (DM) characterized by symptoms, such as pain, sensory disturbances, and reduced quality of life. Currently, there is no definitive cure. Management focuses on controlling blood glucose and alleviating symptoms through pharmacological and non-pharmacological therapies. The aim of this study is to analyze the evidence regarding the efficacy of alpha-lipoic acid (ALA) supplementation in the management of DPN.

Results

A systematic search across multiple databases was conducted using keywords, such as “diabetes mellitus,” “diabetes mellitus type I,” “diabetes mellitus type II,” “alpha-lipoic acid,” and “ALA supplementation.” A total of 15 studies met the inclusion criteria. Of the 23 outcomes analyzed, 19 showed significant differences in favor of alpha-lipoic acid (ALA) supplementation at different doses versus a placebo or other treatments. Notable improvements were observed in Total Symptom Score (TSS) paresthesia (SMD = −1.04; 95 % CI = −1.24 to −0.84; p < 0.00001), TSS numbness (SMD = −0.23; 95 % CI = −0.44 to −0.01; p = 0.04), and the Hamburg Pain Adjective List (HPAL) (SMD = −1.00; 95 % CI = −1.15 to −0.85; p < 0.00001), among others. These improvements were particularly evident for symptoms, such as paresthesia, numbness, and burning sensations, especially at a dose of 600 mg/day. In contrast, four of the outcomes HbA1c, nitric oxide levels, sural sensory nerve action potential, and peroneal motor nerve conduction velocity showed no significant changes.

Conclusion

The evidence suggests that ALA, especially at 600 mg/day, is a safe and potentially effective adjunct therapy for symptom management in DPN, although its impact on nerve conduction and long-term glycemic control remains inconclusive.

在这篇文章中，我们进行了一项系统回顾和荟萃分析，评估了补充α -硫辛酸（ALA）对糖尿病多发性神经病变或糖尿病周围神经病变（DPN）患者的生化、临床、炎症和功能参数的影响。共纳入15篇文章，其中12篇对结果进行分析。DPN是糖尿病（DM）的一种慢性并发症，以疼痛、感觉障碍和生活质量下降等症状为特征。目前，尚无确切的治疗方法。治疗的重点是通过药物和非药物治疗控制血糖和减轻症状。本研究的目的是分析关于α -硫辛酸（ALA）补充治疗DPN疗效的证据。结果以“diabetes mellitus”、“diabetes mellitus type I”、“diabetes mellitus type II”、“α -硫辛酸”、“ALA supplement”等关键词对多个数据库进行了系统检索。共有15项研究符合纳入标准。在分析的23个结果中，有19个显示不同剂量的α -硫辛酸（ALA）补充剂与安慰剂或其他治疗相比有显著差异。在总症状评分（TSS）感觉异常（SMD = - 1.04; 95% CI = - 1.24至- 0.84;p < 0.00001）、TSS麻木（SMD = - 0.23; 95% CI = - 0.44至- 0.01;p = 0.04）和汉堡疼痛形容词表（HPAL）（SMD = - 1.00; 95% CI = - 1.15至- 0.85;p < 0.00001）等方面均有显著改善。这些改善对感觉异常、麻木和烧灼感等症状尤其明显，特别是在600毫克/天的剂量下。相比之下，糖化血红蛋白、一氧化氮水平、腓肠感觉神经动作电位、腓运动神经传导速度等4项指标无明显变化。结论尽管ALA对神经传导和长期血糖控制的影响尚不明确，但证据表明ALA，特别是600 mg/天，是一种安全且潜在有效的DPN症状管理辅助治疗。

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引用次数: 0

Association of sodium-glucose cotransporter 2 inhibitors with the risk of incident anxiety and insomnia: a retrospective cohort study using the TriNetX database 钠-葡萄糖共转运蛋白2抑制剂与突发焦虑和失眠风险的关联：使用TriNetX数据库的回顾性队列研究

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2025.103373

Chen-I Chang , Jun-Fu Lin , I-Chieh Chen , Ching-Heng Lin , Hsin-Hua Chen , Ming-Hong Chang , Chien-Lun Tang , Yen-Wei Pai

Aim

Patients with type 2 diabetes have a higher prevalence of anxiety and insomnia. Comparative evidence on mental health outcomes of antihyperglycemic agents remains limited.

Methods

This retrospective, active-comparator, multicenter cohort study utilized data from the TriNetX US Collaborative Network. The study included adults with type 2 diabetes who were treated with metformin in combination with one of the following classes of antihyperglycemic agents: sodium-glucose cotransporter 2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, or glucagon-like peptide 1 receptor agonists (GLP-1 RAs). Propensity score matching was performed.

Results

Among 26,381 matched pairs of SGLT2 inhibitor and DPP-4 inhibitor users, SGLT2 inhibitor use was associated with lower risks of incident anxiety (3.73 % vs 4.82 %; HR 0.87, 95 % CI 0.80–0.95) and insomnia (2.14 % vs 2.73 %; HR 0.89, 95 % CI 0.80–0.99).

Among 24,794 matched pairs of SGLT2 inhibitor and GLP-1 RA users, SGLT2 inhibitor use was associated with a lower risk of anxiety (3.92 % vs 5.29 %; HR 0.79, 95 % CI 0.72–0.85), while the risk of insomnia did not differ significantly (HR 0.93, 95 % CI 0.83–1.05).

Conclusion

SGLT2 inhibitor use was associated with a lower risk of anxiety and, compared with DPP-4 inhibitors, a lower risk of incident insomnia. These findings suggest that mental health outcomes may be relevant when selecting antihyperglycemic agents and warrant further prospective investigation.

目的2型糖尿病患者有较高的焦虑和失眠患病率。关于抗高血糖药物的心理健康结果的比较证据仍然有限。方法这项回顾性、主动比较、多中心队列研究利用了TriNetX美国合作网络的数据。该研究包括成人2型糖尿病患者，他们接受二甲双胍联合以下降糖药之一的治疗：钠-葡萄糖共转运蛋白2 （SGLT2）抑制剂、二肽基肽酶-4 （DPP-4）抑制剂或胰高血糖素样肽1受体激动剂（GLP-1 RAs）。进行倾向评分匹配。结果在26,381对匹配的SGLT2抑制剂和DPP-4抑制剂使用者中，SGLT2抑制剂的使用与较低的突发焦虑（3.73% vs 4.82%; HR 0.87, 95% CI 0.80-0.95）和失眠（2.14% vs 2.73%; HR 0.89, 95% CI 0.80-0.99）风险相关。在24,794对匹配的SGLT2抑制剂和GLP-1 RA使用者中，SGLT2抑制剂的使用与较低的焦虑风险相关（3.92% vs 5.29%; HR 0.79, 95% CI 0.72-0.85），而失眠的风险无显著差异（HR 0.93, 95% CI 0.83-1.05）。结论：与DPP-4抑制剂相比，sglt2抑制剂的使用与较低的焦虑风险相关，并且与较低的失眠风险相关。这些发现表明，心理健康结果可能与选择抗高血糖药物有关，值得进一步的前瞻性研究。

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引用次数: 0

Efficacy and safety of finerenone in the treatment of primary aldosteronism: A prospective clinical study 芬烯酮治疗原发性醛固酮增多症的疗效和安全性：一项前瞻性临床研究。

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2025.103369

Shuo Li , Yifan Zhang , Xuan Liu , Yun Chai, Hongwei Jia, Hua Shu, Yuxin Fan, Li Ding, Ming Liu

Aims

This study aimed to evaluate the safety and efficacy of finerenone in the treatment of primary aldosteronism (PA).

Methods

A total of 15 patients with PA were enrolled. The primary endpoint was the proportion of patients achieving normal serum potassium levels without potassium supplementation at the 4-week (4W) follow-up. Secondary endpoints included changes in serum potassium, 24-h urinary potassium, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Serum creatinine, estimated glomerular filtration rate (eGFR), and hyperkalemia incidence were also assessed during follow-ups.

Results

At baseline, all patients had hypokalemia (serum potassium <3.5 mmol/L). At 4W, 47 % (7/15) of patients achieved normal serum potassium without supplementation. Serum potassium levels significantly increased at the 2W, 4W, and 8W follow-ups compared to baseline (all p < 0.05). SBP significantly decreased at the 4W and 8W follow-ups (all p < 0.05), while DBP showed no significant changes. Increases in serum creatinine and decreases in eGFR were observed, particularly in patients with PA and chronic kidney disease (CKD), although these changes were not statistically significant. No instances of hyperkalemia or unexpected safety concerns were reported.

Conclusion

Finerenone effectively increased serum potassium levels and reduced SBP in PA, demonstrating its potential as a promising treatment option.

目的：本研究旨在评价芬烯酮治疗原发性醛固酮增多症（PA）的安全性和有效性。方法：共纳入15例PA患者。主要终点是在4周（4W）随访期间，在不补充钾的情况下达到正常血钾水平的患者比例。次要终点包括血清钾、24小时尿钾、收缩压（SBP）和舒张压（DBP）的变化。随访期间还评估了血清肌酐、肾小球滤过率（eGFR）和高钾血症的发生率。结果：基线时，所有患者均出现低钾血症（血钾）。结论：非那烯酮可有效提高PA患者的血钾水平，降低收缩压，显示其作为一种有前景的治疗选择的潜力。

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引用次数: 0

Impact of diabetes mellitus on dental pulp tissue pathosis – A scoping review 糖尿病对牙髓组织病变的影响综述。

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2025.103361

Nandita Suresh , Osama Adeel Khan Sherwani , Namrata Suresh , Priyanka Porwal , Vishnupriya K. Sweety , Betsy Joseph , Tuomas Waltimo , Sukumaran Anil

Background

Diabetes mellitus alters dental pulp tissue response through complex inflammatory and calcification processes, yet the full scope of these effects remains incompletely mapped.

Objectives

To chart the evidence regarding diabetes mellitus' impact on dental pulp tissue pathosis, identify patterns in inflammatory, vascular, and mineralization changes, examine differences between Type 1 Diabetes and Type 2 Diabetes effects, assess the influence of glycemic control on pulpal outcomes, and identify knowledge gaps for future research.

Methods

This scoping review followed PRISMA-ScR guidelines and searched Medline, Scopus, Web of Science, and Ebscohost up to August 2024. Two independent reviewers screened studies and extracted data, with a third resolving discrepancies.

Results

Of 609 identified records, 30 met inclusion criteria (13 human, 17 animal studies). Human studies revealed increased inflammatory responses characterized by elevated cytokine levels, thickened blood vessels, and reduced endothelial cells. Older people living with diabetes showed a higher incidence of pulp stones and symptomatic irreversible pulpitis. Animal studies demonstrated severe inflammatory responses, decreased antioxidant activity, and increased calcification. Poorly controlled diabetes was associated with more pronounced pathological changes.

Conclusions

Diabetes mellitus significantly impacts dental pulp through multiple pathways affecting inflammation, vascular structure, and mineralization. Glycemic control emerges as a key modifiable factor, supporting the integration of diabetes status into endodontic treatment planning.

背景：糖尿病通过复杂的炎症和钙化过程改变牙髓组织的反应，但这些影响的全部范围仍不完全清楚。目的：研究糖尿病对牙髓组织病变的影响，确定炎症、血管和矿化变化的模式，检查1型糖尿病和2型糖尿病的差异，评估血糖控制对牙髓预后的影响，并为未来的研究确定知识空白。方法：本综述遵循PRISMA-ScR指南，检索截止到2024年8月的Medline、Scopus、Web of Science和Ebscohost。两名独立审稿人筛选研究并提取数据，第三名审稿人解决差异。结果：在609份确定的记录中，30份符合纳入标准（13份人研究，17份动物研究）。人体研究显示炎症反应增加，其特征是细胞因子水平升高，血管增厚，内皮细胞减少。老年糖尿病患者出现牙髓结石和症状性不可逆牙髓炎的发生率较高。动物实验显示严重的炎症反应，抗氧化活性降低，钙化增加。控制不良的糖尿病与更明显的病理改变相关。结论：糖尿病通过多种途径影响牙髓的炎症、血管结构和矿化。血糖控制是一个关键的可改变因素，支持将糖尿病状况纳入牙髓治疗计划。

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引用次数: 0

Diabetes with low body mass index in India: A secondary analysis of NFHS-5 data 印度低体重指数糖尿病患者：对NFHS-5数据的二次分析

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2025.103371

Saurav Basu , Vansh Maheshwari

Background

The International Diabetes Federation (IDF) recently recognized “Type 5 Diabetes” (“T5DM”) as a distinct entity. Proponents estimate a burden of 6 million cases in India. However, the applicability of this classification in the Indian context, which is dominated by Lean Type 2 Diabetes (T2D), remains debated.

Methods

We conducted a secondary analysis of the National Family Health Survey-5 (2019–2021), comprising 788,974 respondents, to estimate the prevalence of young and middle-aged people (15–49 years) with low BMI Diabetes in India. The proxy phenotype was defined as: BMI <18.5 kg/m² (or age-appropriate z-scores for adolescents), and either Fasting Blood Glucose ≥126 mg/dL, Random Blood Glucose (RBG) ≥200 mg/dL, or self-reported diabetes.

Results

The analysis identified 1351 individuals meeting the low BMI diabetes phenotypic criteria. The weighted prevalence of low BMI Diabetes was 0.19 (95 % CI: 0.18 to 0.21). While the raw sample was predominantly female due to survey design, weighted analysis revealed significantly higher prevalence in males (Female: 0.18 vs. Male: 0.25; p = 0.006). Cases were significantly concentrated in the poorest wealth quintiles (54 %), contrasting with the affluent demographic typically associated with T2D. Extrapolating to the national population and adjusting for 50 % undiagnosed cases, we estimate 2.42 million Indians aged <50 years have low BMI diabetes.

Conclusion

The prevalence of “T5DM” is likely to be substantially lower than previous estimates, even after accounting for underdiagnosis. The primary diabetes burden in non-obese Indian adults is likely Lean T2D driven by visceral adiposity rather than malnutrition.

国际糖尿病联合会（IDF）最近承认“5型糖尿病”（“T5DM”）是一个独特的实体。支持者估计印度有600万病例。然而，在以精益型2型糖尿病（T2D）为主的印度背景下，这种分类的适用性仍然存在争议。方法我们对全国家庭健康调查-5（2019-2021）进行了二次分析，其中包括788,974名受访者，以估计印度15-49岁的中青年（15-49岁）低BMI糖尿病的患病率。代表型定义为：BMI 18.5 kg/m2（或青少年年龄相适应的z分数），空腹血糖≥126 mg/dL，随机血糖(RBG)≥200 mg/dL，或自我报告糖尿病。结果1351例患者符合低BMI糖尿病表型标准。低BMI糖尿病的加权患病率为0.19 （95% CI: 0.18 ~ 0.21）。虽然由于调查设计，原始样本主要是女性，但加权分析显示男性的患病率明显更高（女性：0.18 vs男性：0.25;p = 0.006）。病例明显集中在最贫穷的五分之一（54%），与典型的与T2D相关的富裕人口形成对比。外推到全国人口，并调整50%未确诊病例，我们估计有242万50岁的印度人患有低BMI糖尿病。结论：即使考虑到诊断不足，“T5DM”的患病率可能大大低于以前的估计。非肥胖印度成年人的主要糖尿病负担可能是由内脏肥胖而非营养不良引起的瘦型糖尿病。

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引用次数: 0

Economic evaluation of diabetes prevention interventions in Bangladesh: A modelling study 孟加拉国糖尿病预防干预措施的经济评估：一项模型研究

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2025.103370

Damon Mohebbi , Sanjit Kumar Shaha , Abdul Kuddus , Md Alimul Reza Chowdhury , Hannah Jennings , Naveed Ahmed , Joanna Morrison , Kohenour Akter , Tasmin Nahar , Carina King , Tom Palmer , Rachael Hunter , Ali Kiadaliri , Kishwar Azad , Edward Fottrell , Hassan Haghparast-Bidgoli

Aim

To model the long-term cost-effectiveness of scaling up two prevention interventions against type 2 diabetes mellitus (T2DM), i.e. community mobilisation through participatory learning and action (PLA) and mHealth mobile phone messaging, implemented in rural Bangladesh as part of the “DMagic” trial.

Methods

A health-economic Markov model of the three-arm, cluster-randomised controlled DMagic trial was developed. A cohort of individuals aged 50 years entered the model with impaired glucose tolerance (IGT). Outcomes included the costs (provider perspective), quality-adjusted life-years gained (QALY), incremental cost-effectiveness ratios (ICERs) and incidence of T2DM in a lifetime period. Deterministic and probabilistic sensitivity analyses were performed to reflect uncertainty.

Results

PLA yielded substantial reductions in diabetes incidence with only 25 % of the IGT population developing T2DM (versus 46 % in the control arm). The intervention was cost-effective against control with an ICER of 167 INT$ per QALY gained. The mHealth intervention revealed limited effectiveness at low cost, leading to an ICER of 189 INT$ per QALY gained. At willingness-to-pay ranges between 3 % and 45 % of Bangladesh GDP per capita, PLA demonstrated up to 90 % probability of being cost-effective.

Conclusions

PLA is a low-cost, effective strategy to reduce the burden of T2DM, offering good value for money.

Trial registration

The DMagic trial was registered with the ISRCTN registry, number ISRCTN41083256.

AimTo对扩大2型糖尿病（T2DM）的两种预防干预措施的长期成本效益进行建模，即通过参与式学习和行动（PLA）和移动健康移动电话信息进行社区动员，作为“DMagic”试验的一部分在孟加拉国农村实施。方法建立三臂、集群随机对照DMagic试验的健康经济马尔可夫模型。一组50岁的个体以糖耐量受损（IGT）进入模型。结果包括成本（提供者角度）、获得的质量调整生命年（QALY）、增量成本-效果比（ICERs）和一生中2型糖尿病的发病率。进行确定性和概率敏感性分析以反映不确定性。结果spla显著降低了糖尿病发病率，只有25%的IGT人群发展为2型糖尿病（对照组为46%）。与对照相比，干预措施具有成本效益，每获得一个QALY， ICER为167 INT$。移动医疗干预在低成本下显示出有限的有效性，导致ICER为189 INT$ / QALY。在孟加拉国人均GDP的3%到45%的支付意愿范围内，PLA显示出高达90%的成本效益可能性。结论spla是降低T2DM患者负担的一种低成本、有效的策略，物有所值。试验注册DMagic试验在ISRCTN注册中心注册，注册号为ISRCTN41083256。

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引用次数: 0

Highlights of the current issue 当前问题的重点

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2026.103377

Ningjian Wang , Anoop Misra

引用次数: 0

Insulin resistance is associated with incident prediabetes and type 2 diabetes in normoglycemic individuals 在血糖正常的个体中，胰岛素抵抗与前驱糖尿病和2型糖尿病有关

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.dsx.2025.103372

Judy Z. Louie , Dov Shiffman , James B. Meigs , Steven W. Taylor , Olle Melander , Fahim Abbasi , Michael J. McPhaul

Aims

Testing insulin resistance could help improve physician assessment of patients’ risk of prediabetes or type 2 diabetes (T2D), even among normoglycemic individuals.

Methods

The longitudinal study followed 16,333 normoglycemic participants in a nation-wide employer-sponsored health assessment program starting in August 2020 with a median follow-up time of 2.9 years for incident prediabetes or T2D. The probability of insulin resistance (IRRS) was calculated from fasting intact insulin and C-peptide serum levels. Incident events had fasting plasma glucose level ≥100 mg/dL (≥5.6 mmol/L), HbA1c ≥ 5.7 % (≥38.8 mmol/mol), or a self-reported physician diagnosis of T2D.

Results

The study population had a median age of 43 years at baseline (31 % men). IRRS was <8 % for participants in the bottom tertile of the distribution compared with >20 % for those in the top tertile. Participants in the top tertile of IRRS had 43 % greater risk of incident prediabetes or T2D (adjusted hazard ratio, aHR = 1.43 [95 % CI, 1.31–1.57], P < 0.001) compared with those in the bottom tertile, in a model that adjusted for age, sex, BMI, and HbA1c.

Conclusions

Elevated IRRS is associated with incident prediabetes or T2D regardless of established risk factors. Evaluating insulin resistance in normoglycemic patients may improve T2D prevention efforts.

目的检测胰岛素抵抗有助于提高医生对糖尿病前期或2型糖尿病（T2D）风险的评估，即使在血糖正常的人群中也是如此。从2020年8月开始，这项纵向研究随访了16333名血糖正常的参与者，他们参加了一项全国性的雇主资助的健康评估项目，对糖尿病前期或糖尿病前期的随访时间为2.9年。根据空腹完整胰岛素和c肽水平计算胰岛素抵抗（IRRS）的概率。事件发生时，空腹血糖水平≥100mg /dL(≥5.6 mmol/L)，糖化血红蛋白≥5.7%(≥38.8 mmol/mol)，或自述医师诊断为T2D。结果研究人群基线时的中位年龄为43岁（31%为男性）。在分布的底层四分之一的参与者中，IRRS为8%，而顶层四分之一的参与者为20%。在一个调整了年龄、性别、BMI和HbA1c的模型中，IRRS的前五分位数的参与者发生前驱糖尿病或T2D的风险比后五分位数的参与者高43%（校正风险比，aHR = 1.43 [95% CI, 1.31-1.57], P < 0.001）。结论不论已知的危险因素如何，IRRS升高与糖尿病前期或T2D的发生有关。评估血糖正常患者的胰岛素抵抗可能会改善t2dm的预防工作。

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引用次数: 0

Ketosis-prone type 2 diabetes in Caucasian adults: a follow-up cohort analysis 白种人成人易患酮症的2型糖尿病：随访队列分析

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-12-22 DOI: 10.1016/j.dsx.2025.103360

Adrienn Kovács , Brigitta Teutsch , Dániel S. Veres , Pál Pánczél , Krisztina Lukács , Emese Sipter , Péter Hegyi , Nóra Hosszúfalusi

Aim

To assess the prevalence, baseline features, and long-term clinical course of ketosis-prone type 2 diabetes in adult Caucasians presenting with new-onset diabetic ketoacidosis or ketosis.

Methods

Clinical data were retrospectively retrieved from electronic medical records, with longitudinal follow-up available. Participants were classified as type 1, latent autoimmune diabetes of adults, ketosis-prone type 2, or non-ketotic type 2 diabetes according to ketosis status, diabetes-related autoantibodies, and fasting C-peptide (within the reference range for ketosis-prone type 2 diabetes). Descriptive statistics and regression models were applied to compare clinical characteristics across diabetes groups.

Results

Of 183 newly diagnosed patients, 86 presented with ketosis, including 22 with ketosis-prone type 2 diabetes. Compared with those with type 1 diabetes, these individuals were older (mean ± SD; 54.9 ± 12.6 vs. 34.8 ± 12.6 years, p < 0.0001), had higher body mass index (31.5 ± 5.6 kg/m² vs. 22.5 ± 3.7 kg/m², p < 0.0001), higher glycated hemoglobin (13.3 ± 3.1 % vs. 10.8 ± 3.2 %, p = 0.0047), and greater hepatic steatosis (hepatic steatosis index: 45.4 ± 6.2 vs. 34.7 ± 4.7, p < 0.0001). In ketosis-prone type 2 diabetes, beta-cell function remained preserved long after the index episode (5–10 years: 4.37 ± 2.45 ng/mL; 10–15 years: 2.85 ± 1.54 ng/mL).

Conclusion

One-fourth of adult Caucasian patients with new-onset diabetic ketosis had ketosis-prone type 2 diabetes, characterised by negative autoantibodies, preserved C-peptide, and sustained long-term endogenous insulin secretion.

目的评估新发糖尿病酮症酸中毒或酮症的成年白种人中易发生酮症的2型糖尿病的患病率、基线特征和长期临床病程。方法回顾性从电子病历中检索临床资料，并进行纵向随访。根据酮症状态、糖尿病相关自身抗体和空腹c肽（在酮症倾向2型糖尿病的参考范围内），参与者被分为1型、成人潜伏自身免疫性糖尿病、酮症倾向2型糖尿病或非酮症2型糖尿病。采用描述性统计和回归模型比较糖尿病组的临床特征。结果在183例新诊断患者中，86例出现酮症，其中22例伴有酮症易发的2型糖尿病。与1型糖尿病患者相比，这些个体年龄更大（平均±SD: 54.9±12.6岁vs. 34.8±12.6岁，p < 0.0001），体重指数更高（31.5±5.6 kg/m2 vs. 22.5±3.7 kg/m2, p < 0.0001），糖化血红蛋白更高（13.3±3.1% vs. 10.8±3.2%,p = 0.0047），肝脂肪变性更严重（肝脂肪变性指数：45.4±6.2 vs. 34.7±4.7,p < 0.0001）。在酮症易感的2型糖尿病中，β细胞功能在指数发作后仍保持很长时间（5-10年：4.37±2.45 ng/mL； 10-15年：2.85±1.54 ng/mL）。结论新发糖尿病酮症的成年高加索患者中有1 / 4为酮症易感型2型糖尿病，以自身抗体阴性、c肽保存、长期持续内源性胰岛素分泌为特征。

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引用次数: 0

Effects of millet consumption on metabolic homeostasis (glycemic control and lipid profiles) in adults: A systematic review 谷子食用对成人代谢稳态（血糖控制和脂质谱）的影响：一项系统综述。

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2025-12-19 DOI: 10.1016/j.dsx.2025.103359

Nisarga S. Naik , Nikhil Nadiger , Arpita Mukhopadhyay

Objective

The aim of the study was to systematically review the literature to analyze the effect of millet consumption on metabolic homeostasis in adults.

Method

We conducted a systematic review of literature to evaluate effect of millet-consumption on metabolic homeostasis. Science Direct and PubMed databases were used to search articles till January 14th, 2025. Quality of randomized-controlled and crossover-studies were reported using the Cochrane-Risk-of-Bias-Assessment-scale, while that of non-randomized studies were reported using the Risk-of-Bias-in-Non-Randomized-Studies-of-Interventions-scale.

Results

One randomized-controlled study, three randomized-crossover studies, and two non-randomized studies were included. In participants with type 2 diabetes (T2DM), multigrain rotis prepared from finger millet, foxtail millet, sorghum, jowar, oats and maize reduced glycated hemoglobin (HbA1c) and low density lipoprotein cholesterol (LDL-c) levels, foxtail millet dosas reduced postprandial blood glucose levels and food prepared from heat-treated barnyard grains reduced fasting blood glucose (FBG) and LDL-c levels. Food prepared from powdered finger millet and little millet reduced FBG levels in prediabetics.

Conclusion

Consumption of millet-based foods could improve glycemic response and LDL-c levels in individuals with T2DM. Both millet type and preparation methods influenced glycemic response. Future well-controlled trials on subjects from multiple ethnicities are needed for generating robust and actionable evidence of the role of millet consumption on metabolic health.

Systemic review registration

International Prospective Register of Systematic Reviews (PROSPERO) CRD42023431941.

目的：系统回顾相关文献，分析谷子食用对成人代谢稳态的影响。方法：通过系统的文献综述，评价食用小米对代谢稳态的影响。使用Science Direct和PubMed数据库检索2025年1月14日之前的文章。使用cochrane - risk -of- bias - assessment量表报告随机对照和交叉研究的质量，而使用非随机干预研究的risk -of- bias -量表报告非随机对照和交叉研究的质量。结果：纳入1项随机对照研究、3项随机交叉研究和2项非随机研究。在2型糖尿病（T2DM）患者中，用谷子、谷子、高粱、玉米、燕麦和玉米制作的杂粮rotis降低了糖化血红蛋白（HbA1c）和低密度脂蛋白胆固醇（LDL-c）水平，谷子剂量降低了餐后血糖水平，用热处理的谷仓谷物制作的食物降低了空腹血糖（FBG）和LDL-c水平。由小米粉和小小米制成的食物降低了糖尿病前期患者的空腹血糖水平。结论：食用小米类食物可改善T2DM患者的血糖反应和LDL-c水平。谷子类型和制备方法均影响血糖反应。未来需要对多种族受试者进行对照良好的试验，以产生强有力的、可操作的证据，证明小米消费对代谢健康的作用。系统评价注册：国际前瞻性系统评价注册（PROSPERO） CRD42023431941。

{"title":"Effects of millet consumption on metabolic homeostasis (glycemic control and lipid profiles) in adults: A systematic review","authors":"Nisarga S. Naik , Nikhil Nadiger , Arpita Mukhopadhyay","doi":"10.1016/j.dsx.2025.103359","DOIUrl":"10.1016/j.dsx.2025.103359","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to systematically review the literature to analyze the effect of millet consumption on metabolic homeostasis in adults.</div></div><div><h3>Method</h3><div>We conducted a systematic review of literature to evaluate effect of millet-consumption on metabolic homeostasis. Science Direct and PubMed databases were used to search articles till January 14th, 2025. Quality of randomized-controlled and crossover-studies were reported using the Cochrane-Risk-of-Bias-Assessment-scale, while that of non-randomized studies were reported using the Risk-of-Bias-in-Non-Randomized-Studies-of-Interventions-scale.</div></div><div><h3>Results</h3><div>One randomized-controlled study, three randomized-crossover studies, and two non-randomized studies were included. In participants with type 2 diabetes (T2DM), multigrain rotis prepared from finger millet, foxtail millet, sorghum, jowar, oats and maize reduced glycated hemoglobin (HbA1c) and low density lipoprotein cholesterol (LDL-c) levels, foxtail millet dosas reduced postprandial blood glucose levels and food prepared from heat-treated barnyard grains reduced fasting blood glucose (FBG) and LDL-c levels. Food prepared from powdered finger millet and little millet reduced FBG levels in prediabetics.</div></div><div><h3>Conclusion</h3><div>Consumption of millet-based foods could improve glycemic response and LDL-c levels in individuals with T2DM. Both millet type and preparation methods influenced glycemic response. Future well-controlled trials on subjects from multiple ethnicities are needed for generating robust and actionable evidence of the role of millet consumption on metabolic health.</div></div><div><h3>Systemic review registration</h3><div>International Prospective Register of Systematic Reviews (PROSPERO) CRD42023431941.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"20 1","pages":"Article 103359"},"PeriodicalIF":3.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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