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

{"title":"Highlights of the current issue","authors":"Ningjian Wang , Anoop Misra","doi":"10.1016/j.dsx.2025.103358","DOIUrl":"10.1016/j.dsx.2025.103358","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 12","pages":"Article 103358"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798577","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}

{"title":"Efficacy and Safety of Cinnamomum zeylanicum (Ceylon cinnamon) for diabetes mellitus: a randomized, double blind, placebo-controlled clinical trial","authors":"Priyanga Ranasinghe ,&nbsp;Priyadarshani Galappatthy ,&nbsp;Godwin R. Constantine ,&nbsp;Ranil Jayawardena ,&nbsp;Hasitha D. Weeratunga ,&nbsp;Sirimal Premakumara ,&nbsp;Prasad Katulanda","doi":"10.1016/j.dsx.2025.103357","DOIUrl":"10.1016/j.dsx.2025.103357","url":null,"abstract":"<div><h3>Background</h3><div>The search for novel antihyperglycemic agents from herbal medicines has highlighted cinnamon, which contains biologically active compounds with insulin-mimetic effects <em>in-vitro</em>. We assessed the efficacy and safety of <em>Cinnamomum zeylanicum</em> (CZ) extract in individuals with Type 2 Diabetes.</div></div><div><h3>Methods</h3><div>A total of 210 individuals with Type 2 Diabetes were randomly assigned in equal numbers to two CZ extract groups (250 mg or 500 mg) and one placebo group. The primary outcome was change in glycaemic control (HbA1c and fasting plasma glucose [FPG]) from baseline. Secondary outcomes included serum lipids, insulin resistance and β-cell function, systolic (SBP) and diastolic (DBP) blood pressure, and anthropometric parameters. Multiple regression analyses were conducted with change in FPG or HbA1c from baseline as the dependent variables and treatment group and covariates as predictors.</div></div><div><h3>Results</h3><div>The mean age of participants was 58.6 ± 8.2 years, with 42.9 % (n = 90) being male; 186 completed the four-month follow-up. Both FPG and HbA1c significantly declined in the CZ extract groups compared to baseline, accompanied by reduced insulin resistance and improved β-cell function (p &lt; 0.05). At four months, total and LDL cholesterol were significantly lower in the 500 mg CZ extract group (p &lt; 0.05). Regression analyses identified CZ extract treatment as a significant predictor of changes in both FPG and HbA1c.</div></div><div><h3>Conclusions</h3><div>This randomized controlled trial developed and tested a CZ-based intervention for Type 2 Diabetes, demonstrating its promising efficacy and safety. Further studies are warranted to explore its potential as a pharmaceutical agent for diabetes management.</div></div><div><h3>Trial registration</h3><div>Sri Lanka Clinical Trials Registry, identifier: SLCTR/2017/010 (<span><span>http://slctr.lk/trials/714</span><svg><path></path></svg></span>). Registered on April 05, 2017; Study protocol version 3.1 (March 21, 2017)</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 12","pages":"Article 103357"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784395","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}

{"title":"Assessing the quality and guideline-concordance of AI-powered chatbots in nutritional management of diabetes","authors":"Maryame Ben Lafqih ,&nbsp;Faiçal Ait Lahbib ,&nbsp;Kaltoum Boutahar ,&nbsp;Hanane Azargui ,&nbsp;Rachid Elfatimy ,&nbsp;Imane Motaib","doi":"10.1016/j.dsx.2025.103355","DOIUrl":"10.1016/j.dsx.2025.103355","url":null,"abstract":"<div><h3>Aims</h3><div>This study assessed the performance of ChatGPT and Gemini in delivering evidence-based, personalized dietary recommendations for diabetes management.</div></div><div><h3>Methods</h3><div>Fifty-two simulated patient cases covering nine diabetes-related categories were analyzed. We evaluated nutritional recommendations from ChatGPT and Gemini using the Analytic Hierarchy Process (AHP), focusing on clinical relevance, alignment with guidelines, personalization, and practicality. Chatbot performance was compared both overall and across diabetes categories.</div></div><div><h3>Results</h3><div>Gemini (version 1.5 Flash) significantly outperformed ChatGPT (GPT-4) in overall AHP scores (Gemini: 4.34 (IQR 3.85–4.56), ChatGPT: 3.79 (IQR 3.28–4.30), <em>p</em> &lt; 0.001). Gemini performed better in complex cases, particularly chronic kidney disease cases (<em>p</em> = 0.047) and malnutrition or post-bariatric surgery (<em>p</em> = 0.003). No significant differences were observed in other categories (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Gemini outperformed ChatGPT, showing higher guideline alignment. These findings support refining AI tools for reliable, personalized nutrition in diabetes care.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 12","pages":"Article 103355"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738209","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}

{"title":"Authors’ Reply to Letter to the Editor by Emily N.C. Manoogian et al","authors":"Meng Chen,&nbsp;Lan Xu,&nbsp;Victor W. Zhong","doi":"10.1016/j.dsx.2025.103330","DOIUrl":"10.1016/j.dsx.2025.103330","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 12","pages":"Article 103330"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716838","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}

{"title":"Association of sucralose consumption with insulin response and sensitivity","authors":"Shada Kodumayil ,&nbsp;Ahmed Gebril ,&nbsp;Soumya Nair ,&nbsp;Insiya Saifudeen ,&nbsp;Abrar Alhermi ,&nbsp;Najla Shamsi ,&nbsp;Naji Alamuddin ,&nbsp;Nitya Kumar","doi":"10.1016/j.dsx.2025.103343","DOIUrl":"10.1016/j.dsx.2025.103343","url":null,"abstract":"<div><h3>Background and aim</h3><div>Use of non-nutritive sweeteners (NNS) is widespread in foods and beverages and are believed to have little to no impact on glucose metabolism. Nonetheless, recent studies have shown sucralose may not be as innocuous as previously thought. This review was conducted to summarize the evidence available on the impact of sucralose on insulin response and sensitivity.</div></div><div><h3>Methods</h3><div>Evidence on sucralose was searched in MEDLINE and Google scholar databases using search strings that incorporated synonyms of sucralose, insulin, response and sensitivity.</div></div><div><h3>Results</h3><div>Of the 16 studies that reported impact of sucralose on insulin response, 8 found an increased insulin response following ingestion of sucralose, 7 did not find any impact and 1 found a favorable impact. Of the 8 studies describing the effect of sucralose on insulin sensitivity, 6 reported a decrease, 1 found an increase and the remaining one found no change.</div></div><div><h3>Conclusion</h3><div>Intervention studies report inconsistent effects of sucralose, with approximately half suggesting adverse impacts on insulin response and sensitivity. A meta-analysis is warranted to quantitatively synthesize the effects of sucralose exposure on insulin metabolism.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 12","pages":"Article 103343"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694401","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}

{"title":"Prevalence of isolated nocturnal hypertension among patients with type 2 diabetes mellitus","authors":"Walter Gaston Espeche ,&nbsp;Gustavo Cerri ,&nbsp;Julian Minetto ,&nbsp;Ezequiel Giordani ,&nbsp;Mariano Costa ,&nbsp;Sofia Pacho Calvo ,&nbsp;Jose Esteba Costa Gil ,&nbsp;Martin Salazar","doi":"10.1016/j.dsx.2025.103353","DOIUrl":"10.1016/j.dsx.2025.103353","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence of isolated nocturnal hypertension (INH) in patients with type 2 diabetes (T2D), and secondarily, to assess its frequency in those with normal office blood pressure and not receiving antihypertensive treatment.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study including patients aged ≥18 years with T2D who underwent 24-h ambulatory blood pressure monitoring (ABPM) between January 2022 and December 2024. INH was defined as mean nocturnal BP ≥ 120/70 mmHg with normal daytime BP (&lt;135/85 mmHg). Office BP was classified into four categories according to European guidelines. Target organ damage (TOD) was assessed in a subsample through echocardiography and urinary albumin-to-creatinine ratio.</div></div><div><h3>Results</h3><div>A total of 439 patients were included (57.6 % women; mean age 56.5 ± 10.4 years). The prevalence of INH was 21.9 % (95 % CI 0.18–0.26). Among individuals with normal office BP and no antihypertensive treatment (n = 57), INH prevalence was 31.6 %, being the most frequent phenotype of masked hypertension. INH was associated with lower HDL-C, higher triglycerides, and greater evidence of subclinical TOD compared to normotensive patients.</div></div><div><h3>Conclusion</h3><div>INH is highly prevalent in individuals with T2D, especially among those untreated and with normal office BP. Given its association with subclinical TOD and lack of clinical predictors, ABPM should be considered in all T2D patients regardless of office BP values.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 12","pages":"Article 103353"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727866","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}

{"title":"Delayed breakfast in type 2 diabetes: Critical gaps and translation barriers","authors":"Himel Mondal,&nbsp;Anupkumar Dhanvijay","doi":"10.1016/j.dsx.2025.103294","DOIUrl":"10.1016/j.dsx.2025.103294","url":null,"abstract":"<div><div>We respond to the article “Modifying the timing of breakfast improves postprandial glycaemia in people with type 2 diabetes: A randomised controlled trial” by Bravo-Garcia et al. While the study introduces an intriguing strategy for postprandial glycemic control, several methodological modification and detailed reporting could be done. Key variables such as participants' sleep-wake timing, daily schedules, and evening routines, which influence glucose metabolism, could be reported. Limited details on medication timing and exercise standardization could be taken care of. Additionally, cultural and socioeconomic factors, particularly in developing countries like India, challenge the practicality of delayed breakfast protocols. The physiological implications of fasting, including the Somogyi effect, warrant further exploration. These highlight the need for more comprehensive studies addressing individual, cultural, and socioeconomic factors to enhance the translational potential of breakfast timing interventions for glycemic control.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103294"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986179","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}

{"title":"Low dose pioglitazone (7.5 mg) provides efficacious glycemic control in Asian Indian patients with poorly controlled diabetes compared to 15 mg: A pilot randomized controlled parallel-group open-label trial over 12 months","authors":"Rohit Barnabas ,&nbsp;Shruti Bhide ,&nbsp;Saba Samad Memon ,&nbsp;Manjiri Karlekar ,&nbsp;Chetan Phirke ,&nbsp;Saurabh Patil ,&nbsp;Vijayadhaarani Sekar ,&nbsp;Vyankatesh Shivane ,&nbsp;Anurag Lila ,&nbsp;Tushar Bandgar","doi":"10.1016/j.dsx.2025.103335","DOIUrl":"10.1016/j.dsx.2025.103335","url":null,"abstract":"<div><h3>Aims</h3><div>We aimed to compare the 1-year efficacy and safety of 7.5 mg versus 15 mg pioglitazone in Asian Indian patients with type 2 diabetes due to lack of long-term data in lower doses.</div></div><div><h3>Methods</h3><div>In this open-label randomized controlled study, 60 patients were assigned to receive either 7.5 mg or 15 mg of pioglitazone daily. Efficacy endpoints included HbA1c, fasting and postprandial venous glucose. Additionally, lipid profile, liver enzymes, and DXA-based body composition, BMD, weight gain, hemoglobin, and adverse events were performed.</div></div><div><h3>Results</h3><div>Both doses achieved significant HbA1c reduction from baseline (−0.95 % in 7.5 mg, −0.9 % in 15 mg) and postprandial venous glucose (median absolute difference −50 and −46 mg/dl), with non-inferiority of the lower dose. Weight gain occurred in both groups (0.95 kg vs 1.3 kg), mainly due to increased fat mass, with a trend toward greater and earlier gain in the 15 mg arm. Lipid parameters, hepatic enzymes, and body composition parameters were comparable across arms, while there was significant reduction in SGOT and VLDL within individual groups. No significant differences in hypoglycemia, edema, BMD loss, or fractures were observed. The major limitations of the study were open label design, single tertiary care center setting, imperfect randomization in fasting glucose, LDL, and total cholesterol between groups and missing data in DXA scan at follow up.</div></div><div><h3>Conclusion</h3><div>Pioglitazone 7.5 mg is an effective and well-tolerated alternative to 15 mg in Asian Indian patients with type 2 diabetes.</div></div><div><h3>Clinical trials registry of india registration number</h3><div>CTRI/2021/09/036149.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103335"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617461","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}

{"title":"Gliclazide in type 2 diabetes: Cost-effective and clinically relevant in resource-limited settings","authors":"Banshi Saboo ,&nbsp;Nitin Kapoor ,&nbsp;Balaji Jaganmohan ,&nbsp;Abdul Zargar ,&nbsp;Saptarshi Bhattacharya ,&nbsp;Rakesh Sahay ,&nbsp;Shehla Shaikh ,&nbsp;J.J. Mukherjee","doi":"10.1016/j.dsx.2025.103336","DOIUrl":"10.1016/j.dsx.2025.103336","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103336"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650314","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}

{"title":"Impact of sodium-glucose co-transporter-2 inhibitor combined with mineralocorticoid receptor antagonist therapy versus either agent alone in individuals with chronic kidney disease: A systematic review and meta-analysis","authors":"Deep Dutta ,&nbsp;A.B.M. Kamrul-Hasan ,&nbsp;Sweekruti Jena ,&nbsp;Kunal Mahajan ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2025.103334","DOIUrl":"10.1016/j.dsx.2025.103334","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose co-transporter-2 inhibitor (SGLT2i) with mineralocorticoid receptor antagonist (MRA) combination therapy (SMCT) hypothetically appears feasible and rational, given their complementary mechanisms of action. This systematic review and meta-analysis (SRM) assessed the effectiveness and safety of SMCT compared to either agent alone in CKD.</div></div><div><h3>Methods</h3><div>Electronic databases were searched for articles evaluating SMCT in CKD as compared to SGLT2i or MRA alone. The primary outcome was percent-change in urine albumin-to-creatinine ratio (UACR%). Secondary outcomes were changes in glomerular filtration-rate (eGFR), UACR&gt;30 % decline, systolic blood pressure (SBP), potassium, total adverse-events (TAEs), severe adverse-events (SAEs), hypotension and acute kidney injury (AKI).</div></div><div><h3>Results</h3><div>Data from 8 studies (15,583 adults) having age 53–76 years, BMI 28–33 kg/m², HbA1c 6–8 % and eGFR 32–73 ml/min/1.73 m² were analyzed. SMCT was associated with significant reduction in UACR % as compared to MRA [MD-12.83 %(95 %CI: 19.49,-6.17); P &lt; 0.001; I² = 93 %] or SGLT2i [MD-26.30 % (95 %CI: 31.93,-20.68); P &lt; 0.001; I² = 60 %]. SMCT users had significantly higher chances of &gt;30 % reduction in UACR compared to MRA [OR6.69(95 %CI:2.00,22.43); P = 0.002; I² = 80 %] or SGLT2i [OR 4.87(95 %CI:1.71,13.83); P &lt; 0.001; I² = 86 %. SMCT users had significantly lower SBP compared to MRA [MD-5.89 mm-Hg(95 %CI: 9.74,-2.04); P = 0.003; I² = 0 %] or SGLT2i [MD-3.49 mm-Hg(95 %CI: 6.64,-0.34); P = 0.03; I² = 0 %]. SMCT users had similar potassium compared to MRA [MD0.08 mmol/L (95 %CI: 0.34,0.50); P = 0.71; I² = 92 %] but higher compared to SGLT2i [MD0.18 mmol/L (95 %CI:0.07,0.29); P = 0.002; I² = 48 %]. SMCT users had TAEs and SAEs similar to MRA, but higher TAEs than SGLT2i. SMCT users had death rates similar to MRA [OR0.33(95 % CI:0.09,1.16); P = 0.08; I² = 0 %] but higher than SGLT2i [OR2.35(95 %CI:1.25,4.40); P = 0.008; I² = 0 %]. SMCT had no impact on eGFR compared to MRA [MD-0.30 ml/min/1.73 m² (95 %CI: 3.11, 2.50); P = 0.83; I² = 0 %] but lower compared to SGLT2i [MD-2.81 ml/min/1.73 m²(95 %CI: 5.06,-0.56); P = 0.01; I² = 0 %]. The occurrence of hypotension and AKI were similar among study groups.</div></div><div><h3>Conclusion</h3><div>SMCT is more effective than MRA or SGLT2i alone in reducing urine protein loss in CKD. SMCT has side-effects profile like MRAs, which is higher than SGLT2i.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103334"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145663419","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}