Pub Date : 2025-01-01DOI: 10.1016/j.dsx.2024.103181
Yue Huang , Jingxuan Wang , Lan Xu, Nannan Feng, Xihao Du, Meng Chen, Yiyuan Li, Guangrui Yang, Hui Wang, Victor W. Zhong
Introduction
Limited systematic assessments of risk factor contributions to the global burden of type 2 diabetes (T2D) across subpopulations hinder targeted policies and resource allocation.
Materials and methods
Utilizing the Global Burden of Disease study (GBD) 2019, we analyzed the disability-adjusted life-years (DALYs) for T2D attributable to 15 risk factors in adults (aged 25+ years) globally and by sex, age, Socio-demographic Index (SDI), and GBD region, from 1990 to 2019. Additionally, we assessed future trends of these risk factors through 2050.
Results
High body-mass index (BMI) emerged as the predominant risk factor in all subpopulations in 2019, with its impact projected to double by 2050. During 1990–2019, males were more affected by smoking, while females by secondhand smoke and household air pollution. The related DALYs increased with age, except for high BMI and smoking peaking at 60–74 years. In 2019, diet high in processed meat ranked second in high SDI regions, contrasting with household air pollution in low SDI regions. National disparities were observed, with Fiji recording the highest rates of DALYs related to both high BMI and dietary risks in 2019, which were approximately 50 and 15 times higher than those observed in Japan, respectively.
Conclusions
Tailored interventions targeting major contributing risk factors specific to each subpopulation are key to the success of the global combat against T2D.
{"title":"Decoding the disproportionate risk factor landscape of global type 2 diabetes burden in adults: An attribution analysis from 1990 to 2050","authors":"Yue Huang , Jingxuan Wang , Lan Xu, Nannan Feng, Xihao Du, Meng Chen, Yiyuan Li, Guangrui Yang, Hui Wang, Victor W. Zhong","doi":"10.1016/j.dsx.2024.103181","DOIUrl":"10.1016/j.dsx.2024.103181","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited systematic assessments of risk factor contributions to the global burden of type 2 diabetes (T2D) across subpopulations hinder targeted policies and resource allocation.</div></div><div><h3>Materials and methods</h3><div>Utilizing the Global Burden of Disease study (GBD) 2019, we analyzed the disability-adjusted life-years (DALYs) for T2D attributable to 15 risk factors in adults (aged 25+ years) globally and by sex, age, Socio-demographic Index (SDI), and GBD region, from 1990 to 2019. Additionally, we assessed future trends of these risk factors through 2050.</div></div><div><h3>Results</h3><div>High body-mass index (BMI) emerged as the predominant risk factor in all subpopulations in 2019, with its impact projected to double by 2050. During 1990–2019, males were more affected by smoking, while females by secondhand smoke and household air pollution. The related DALYs increased with age, except for high BMI and smoking peaking at 60–74 years. In 2019, diet high in processed meat ranked second in high SDI regions, contrasting with household air pollution in low SDI regions. National disparities were observed, with Fiji recording the highest rates of DALYs related to both high BMI and dietary risks in 2019, which were approximately 50 and 15 times higher than those observed in Japan, respectively.</div></div><div><h3>Conclusions</h3><div>Tailored interventions targeting major contributing risk factors specific to each subpopulation are key to the success of the global combat against T2D.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 1","pages":"Article 103181"},"PeriodicalIF":4.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899294","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}
Pub Date : 2024-11-01DOI: 10.1016/j.dsx.2024.103172
Ningjian Wang , Anoop Misra
{"title":"Highlights of the Current Issue","authors":"Ningjian Wang , Anoop Misra","doi":"10.1016/j.dsx.2024.103172","DOIUrl":"10.1016/j.dsx.2024.103172","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103172"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
South Asians are known for their increased predisposition for type 2 diabetes (T2D). We describe the most recent prevalence and trends of diabetes, prediabetes, and undiagnosed diabetes in South Asia based on surveys conducted from 2000 to 2024.
Methods
A comprehensive search was conducted in PubMed, Web of Science and Scopus databases for population-based studies describing diabetes/prediabetes prevalence. Including STEPS surveys, 7261 records were screened for eligibility, of which 89 were included in this analysis. Prevalences and trends of diabetes, undiagnosed diabetes and prediabetes were analysed by country, making male/female and urban/rural comparisons.
Results
Prevalence of diabetes in South Asia has increased from 11.29 % in 2000–2004 to 22.30 % in 2020–2024. Sri Lanka and Pakistan have demonstrated a steep rise in diabetes over the two decades. India and Bangladesh, have also shown a rise in prevalence from 2.5 % (2015–16) to 8.1 % (2019–21) and 5.5 % (2006) to 8.3 % (2018), respectively. Diabetes prevalence among males was higher. Urban prevalence was higher than rural throughout the region, with both sectors showing a rising trend. Prediabetes followed a similar pattern. Despite the high burden, a large proportion remained undiagnosed, being as high as 17.5 % in Delhi, India (2010–11).
Conclusion
Pooled prevalences show a rising burden of diabetes over the past decade, with a considerable proportion being undiagnosed, in South Asia. Urban prevalence is higher than rural prevalence throughout the region. Prediabetes also shows a similar rising trend, with a notable proportion o being undiagnosed, alerting the need for coordinated efforts for early diagnosis, and prevention.
{"title":"Rising trends of diabetes in South Asia: A systematic review and meta-analysis","authors":"Priyanga Ranasinghe , Nethmini Rathnayake , Sameera Wijayawardhana , Hajanthy Jeyapragasam , V. Jithmal Meegoda , Ranil Jayawardena , Anoop Misra","doi":"10.1016/j.dsx.2024.103160","DOIUrl":"10.1016/j.dsx.2024.103160","url":null,"abstract":"<div><h3>Background</h3><div>South Asians are known for their increased predisposition for type 2 diabetes (T2D). We describe the most recent prevalence and trends of diabetes, prediabetes, and undiagnosed diabetes in South Asia based on surveys conducted from 2000 to 2024.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Web of Science and Scopus databases for population-based studies describing diabetes/prediabetes prevalence. Including STEPS surveys, 7261 records were screened for eligibility, of which 89 were included in this analysis. Prevalences and trends of diabetes, undiagnosed diabetes and prediabetes were analysed by country, making male/female and urban/rural comparisons.</div></div><div><h3>Results</h3><div>Prevalence of diabetes in South Asia has increased from 11.29 % in 2000–2004 to 22.30 % in 2020–2024. Sri Lanka and Pakistan have demonstrated a steep rise in diabetes over the two decades. India and Bangladesh, have also shown a rise in prevalence from 2.5 % (2015–16) to 8.1 % (2019–21) and 5.5 % (2006) to 8.3 % (2018), respectively. Diabetes prevalence among males was higher. Urban prevalence was higher than rural throughout the region, with both sectors showing a rising trend. Prediabetes followed a similar pattern. Despite the high burden, a large proportion remained undiagnosed, being as high as 17.5 % in Delhi, India (2010–11).</div></div><div><h3>Conclusion</h3><div>Pooled prevalences show a rising burden of diabetes over the past decade, with a considerable proportion being undiagnosed, in South Asia. Urban prevalence is higher than rural prevalence throughout the region. Prediabetes also shows a similar rising trend, with a notable proportion o being undiagnosed, alerting the need for coordinated efforts for early diagnosis, and prevention.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103160"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701004","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}
Pub Date : 2024-11-01DOI: 10.1016/j.dsx.2024.103155
Jeroen D. Albers , Annemarie Koster , Bengisu Sezer , Rachelle Meisters , Miranda T. Schram , Simone J.P.M. Eussen , Nicole H.T.M. Dukers , Maria W.J. Jansen , Coen D.A. Stehouwer , Jeroen Lakerveld , Hans Bosma
Aims
This study investigates the interplay between socioeconomic position (SEP), the residential food environment, walkability, greenspace, and type 2 diabetes (T2D), particularly whether the environmental factors mediate the association between SEP and T2D.
Methods
SEP, T2D status, residential Food Environment Healthiness Index (FEHI), number of fast-food outlets (FF), walkability index (WI), and proportion of greenspace (GS) were ascertained in 9188 participants. The associations between SEP, the environment and T2D were modeled with logistic regression and survival analysis. The proportion of mediation of the association between SEP and T2D was estimated with causal mediation analysis.
Results
Lower SEP was associated with higher risk of T2D. Hazard ratios (HR) were 2.03 (95 % CI 1.60–2.58), 1.79 (1.40–2.30) and 1.77 (1.21–2.58) for an interquartile range decrease (IQR) of education, income, and occupation, respectively. HRs for IQR changes of the environmental factors were: FEHI 1.20 (1.00–1.43), FF 0.87 (0.76–0.99), WI 1.23 (0.95–1.58) and GS 1.16 (0.96–1.43). Regression on prevalent T2D yielded similar results. Lower socioeconomic position was associated with a less healthy environment (e.g., FEHI −0.10 (−0.12–−0.07) for education). Environmental exposures mediated between 0.1 % (−0.7–0.9) and 2.6 % (0.4–5.2) of the cross-sectional associations and 0.3 % (−8.6–8.6) and 8.5 % (2.3–27.4) of the longitudinal associations.
Conclusions
People with lower SEP had higher risk and prevalence of T2D and lived in a slightly less healthy residential environment. The association between SEP and T2D is not strongly mediated by FEHI, FF, WI, or GS.
{"title":"The mediating role of the food environment, greenspace, and walkability in the association between socioeconomic position and type 2 diabetes — The Maastricht Study","authors":"Jeroen D. Albers , Annemarie Koster , Bengisu Sezer , Rachelle Meisters , Miranda T. Schram , Simone J.P.M. Eussen , Nicole H.T.M. Dukers , Maria W.J. Jansen , Coen D.A. Stehouwer , Jeroen Lakerveld , Hans Bosma","doi":"10.1016/j.dsx.2024.103155","DOIUrl":"10.1016/j.dsx.2024.103155","url":null,"abstract":"<div><h3>Aims</h3><div>This study investigates the interplay between socioeconomic position (SEP), the residential food environment, walkability, greenspace, and type 2 diabetes (T2D), particularly whether the environmental factors mediate the association between SEP and T2D.</div></div><div><h3>Methods</h3><div>SEP, T2D status, residential Food Environment Healthiness Index (FEHI), number of fast-food outlets (FF), walkability index (WI), and proportion of greenspace (GS) were ascertained in 9188 participants. The associations between SEP, the environment and T2D were modeled with logistic regression and survival analysis. The proportion of mediation of the association between SEP and T2D was estimated with causal mediation analysis.</div></div><div><h3>Results</h3><div>Lower SEP was associated with higher risk of T2D. Hazard ratios (HR) were 2.03 (95 % CI 1.60–2.58), 1.79 (1.40–2.30) and 1.77 (1.21–2.58) for an interquartile range decrease (IQR) of education, income, and occupation, respectively. HRs for IQR changes of the environmental factors were: FEHI 1.20 (1.00–1.43), FF 0.87 (0.76–0.99), WI 1.23 (0.95–1.58) and GS 1.16 (0.96–1.43). Regression on prevalent T2D yielded similar results. Lower socioeconomic position was associated with a less healthy environment (e.g., FEHI −0.10 (−0.12–−0.07) for education). Environmental exposures mediated between 0.1 % (−0.7–0.9) and 2.6 % (0.4–5.2) of the cross-sectional associations and 0.3 % (−8.6–8.6) and 8.5 % (2.3–27.4) of the longitudinal associations.</div></div><div><h3>Conclusions</h3><div>People with lower SEP had higher risk and prevalence of T2D and lived in a slightly less healthy residential environment. The association between SEP and T2D is not strongly mediated by FEHI, FF, WI, or GS.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103155"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.dsx.2024.103157
Ana Paula Bravo-Garcia, Anjana J. Reddy, Bridget E. Radford, John A. Hawley, Evelyn B. Parr
Aims
Investigate the effects of breakfast timing on postprandial glycaemia in adults with type 2 diabetes (T2D), and the impact of a 20-min walk after breakfast.
Methods
Eleven adults with T2D (57 ± 7 y; HbA1c 7.4 ± 1%) participated in a six-week randomised crossover controlled trial comprising three 4-day conditions: Early (0700 h), Mid (0930 h) and Delayed (1200 h). After each condition, a second 4-day intervention of 20-min walk after each condition was undertaken. Standardised breakfast was provided. Interstitial glucose and physical activity were measured. Incremental area under the curve (iAUC) 2-h post-breakfast, 24-h iAUC, and fasting glucose were analysed with linear mixed-effects models. Cohen's d of the 2-h iAUC post-breakfast 20-min walk was calculated.
Results
Mid and Delayed had lower 2-h post-breakfast iAUC (p < 0.002, −57 mmol/L×2h; p < 0.02, −41 mmol/L×2h) compared to Early. There were no differences in fasting (0600 h) glucose or 24-h iAUC. There was a small effect of the 20-min walk on lowering 2-h post-breakfast iAUC for Early (d = 0.35) and Delayed (d = 0.37), with no effect in Mid.
Conclusion
In people with T2D, delaying breakfast from 0700 h to mid-morning or midday reduced postprandial glycaemia. Additional post-meal walking for 20 min had a small effect in lowering postprandial glycaemia when breakfast was at 0700 h or midday, but provided no additional benefit when breakfast was at mid-morning.
{"title":"Modifying the timing of breakfast improves postprandial glycaemia in people with type 2 diabetes: A randomised controlled trial","authors":"Ana Paula Bravo-Garcia, Anjana J. Reddy, Bridget E. Radford, John A. Hawley, Evelyn B. Parr","doi":"10.1016/j.dsx.2024.103157","DOIUrl":"10.1016/j.dsx.2024.103157","url":null,"abstract":"<div><h3>Aims</h3><div>Investigate the effects of breakfast timing on postprandial glycaemia in adults with type 2 diabetes (T2D), and the impact of a 20-min walk after breakfast.</div></div><div><h3>Methods</h3><div>Eleven adults with T2D (57 ± 7 y; HbA1c 7.4 ± 1%) participated in a six-week randomised crossover controlled trial comprising three 4-day conditions: Early (0700 h), Mid (0930 h) and Delayed (1200 h). After each condition, a second 4-day intervention of 20-min walk after each condition was undertaken. Standardised breakfast was provided. Interstitial glucose and physical activity were measured. Incremental area under the curve (iAUC) 2-h post-breakfast, 24-h iAUC, and fasting glucose were analysed with linear mixed-effects models. Cohen's d of the 2-h iAUC post-breakfast 20-min walk was calculated.</div></div><div><h3>Results</h3><div>Mid and Delayed had lower 2-h post-breakfast iAUC (p < 0.002, −57 mmol/L×2h; p < 0.02, −41 mmol/L×2h) compared to Early. There were no differences in fasting (0600 h) glucose or 24-h iAUC. There was a small effect of the 20-min walk on lowering 2-h post-breakfast iAUC for Early (d = 0.35) and Delayed (d = 0.37), with no effect in Mid.</div></div><div><h3>Conclusion</h3><div>In people with T2D, delaying breakfast from 0700 h to mid-morning or midday reduced postprandial glycaemia. Additional post-meal walking for 20 min had a small effect in lowering postprandial glycaemia when breakfast was at 0700 h or midday, but provided no additional benefit when breakfast was at mid-morning.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103157"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.dsx.2024.103168
Jenny Elizabeth Price , Kazuya Fujihara , Satoru Kodama , Katsuya Yamazaki , Hiroshi Maegawa , Tatsuya Yamazaki , Hirohito Sone , Japan Diabetes Clinical Data Management Study Group (JDDM study group)
Objective
To evaluate whether typical machine learning models that mimic specialists’ care can successfully reproduce information, not only on whether to prescribe medications but also which hypoglycemic agents to prescribe as initial treatment for type 2 diabetes.
Research design and methods
A medical records database containing prescriptions for medications for 16,005 patients who visited a diabetologist's office for the first time was utilized to train five typical machine learning models as well-as a model used for logistic analysis. Prescribed were no medications (diet and exercise therapy), insulin, biguanides (BG), sulfonylureas (SU), dipeptidyl peptidase-4 inhibitors (DPP-4I), alpha-glucosidase inhibitors (α-GI) or glinides. Models were compared based on the F1 score and ROC/AUC scores.
Results
XGBoost, which splits decision-making into three sections, was the top performing model (42 % accuracy) among five models and conventional logistic regression (35 % accuracy). The second highest scoring model was Support Vector Machines, which had an accuracy of 40 %. When using XGBoost to compare decisions on no medication needed vs. needing medication the AUC was 0.96. Insulin vs. oral medications had an AUC of 0.78. With all remaining oral medications removed, the AUC was 0.76.
Conclusions
Among the five models investigated, XGBoost outperformed the other machine learning models examined as well as the traditional logistic model, suggesting that its accuracy had the potential to assist non-specialists in decision-making regarding treatment of patients with type 2 diabetes in the future.
{"title":"Machine learning algorithms mimicking specialists decision making on initial treatment for people with type 2 diabetes mellitus in Japan diabetes data management study (JDDM76)","authors":"Jenny Elizabeth Price , Kazuya Fujihara , Satoru Kodama , Katsuya Yamazaki , Hiroshi Maegawa , Tatsuya Yamazaki , Hirohito Sone , Japan Diabetes Clinical Data Management Study Group (JDDM study group)","doi":"10.1016/j.dsx.2024.103168","DOIUrl":"10.1016/j.dsx.2024.103168","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether typical machine learning models that mimic specialists’ care can successfully reproduce information<strong>,</strong> not only on whether to prescribe medications but also which hypoglycemic agents to prescribe as initial treatment for type 2 diabetes.</div></div><div><h3>Research design and methods</h3><div>A medical records database containing prescriptions for medications for 16,005 patients who visited a diabetologist's office for the first time was utilized to train five typical machine learning models as well-as a model used for logistic analysis. Prescribed were no medications (diet and exercise therapy), insulin, biguanides (BG), sulfonylureas (SU), dipeptidyl peptidase-4 inhibitors (DPP-4I), alpha-glucosidase inhibitors (α-GI) or glinides. Models were compared based on the F1 score and ROC/AUC scores.</div></div><div><h3>Results</h3><div>XGBoost, which splits decision-making into three sections, was the top performing model (42 % accuracy) among five models and conventional logistic regression (35 % accuracy). The second highest scoring model was Support Vector Machines, which had an accuracy of 40 %. When using XGBoost to compare decisions on no medication needed vs. needing medication the AUC was 0.96. Insulin vs. oral medications had an AUC of 0.78. With all remaining oral medications removed, the AUC was 0.76.</div></div><div><h3>Conclusions</h3><div>Among the five models investigated, XGBoost outperformed the other machine learning models examined as well as the traditional logistic model, suggesting that its accuracy had the potential to assist non-specialists in decision-making regarding treatment of patients with type 2 diabetes in the future.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103168"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.dsx.2024.103159
Kanika Manral , Anita Singh , Yuvraj Singh
Background and aim
Diabetes mellitus is a chronic metabolic disorder that causes multiple complications in various organs, such as the kidney, liver and cardiovascular system. These complications are the main causes of morbidity and mortality in patients with diabetes. Nanotechnology offers new opportunities for the therapy of diabetes and its multiple complications through site-specific and precise drug delivery. This review summarizes the various studies demonstrating the potential applications of different nanoparticles in diabetes-associated complications.
Method
A literature search was conducted using PubMed, Google Scholar and Scopus databases, focusing on the role of nanoparticles in the improved delivery of various hypoglycemic agents for the treatment of microvascular and macrovascular diabetic complications.
Results
Numerous studies have shown that nanoparticles, such as nanoliposomes, polymeric micelles, dendrimers and metallic nanoparticles, improve the delivery of various hypoglycemic agents. Moreover, nanoparticles have been found to be safer, with improved pharmacokinetic and pharmacodynamic profiles.
Conclusion
This review outlines the significant role of nanotechnology in diabetes and related complications and its superiority over conventional drug delivery.
{"title":"Nanotechnology as a potential treatment for diabetes and its complications: A review","authors":"Kanika Manral , Anita Singh , Yuvraj Singh","doi":"10.1016/j.dsx.2024.103159","DOIUrl":"10.1016/j.dsx.2024.103159","url":null,"abstract":"<div><h3>Background and aim</h3><div>Diabetes mellitus is a chronic metabolic disorder that causes multiple complications in various organs, such as the kidney, liver and cardiovascular system. These complications are the main causes of morbidity and mortality in patients with diabetes. Nanotechnology offers new opportunities for the therapy of diabetes and its multiple complications through site-specific and precise drug delivery. This review summarizes the various studies demonstrating the potential applications of different nanoparticles in diabetes-associated complications.</div></div><div><h3>Method</h3><div>A literature search was conducted using PubMed, Google Scholar and Scopus databases, focusing on the role of nanoparticles in the improved delivery of various hypoglycemic agents for the treatment of microvascular and macrovascular diabetic complications.</div></div><div><h3>Results</h3><div>Numerous studies have shown that nanoparticles, such as nanoliposomes, polymeric micelles, dendrimers and metallic nanoparticles, improve the delivery of various hypoglycemic agents. Moreover, nanoparticles have been found to be safer, with improved pharmacokinetic and pharmacodynamic profiles.</div></div><div><h3>Conclusion</h3><div>This review outlines the significant role of nanotechnology in diabetes and related complications and its superiority over conventional drug delivery.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103159"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748742","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}
Obstructive sleep apnea (OSA) is very common in obese patients. However, why some obese patients have severe OSA while others do not is unclear. Research is limited regarding which structures contribute to upper airway narrowing, especially in Asian patients where bony restrictions is thought to be important.
Methods
Nineteen consecutive patients with BMI ≥35 kg/m2, and newly diagnosed with OSA based on overnight polysomnography were studied using non-contrast magnetic resonance imaging (MRI) of the upper airway during wakefulness.
Results
Patients were divided into two groups, one with severe OSA comprising 11 patients and one without severe OSA having 8 patients. The retro-palatal airway was narrowest in both groups. Patients with severe OSA had a significantly narrower retroglossal airway (0.99 ± 0.48 cm2 vs 2.61 ± 2.02 cm2, p = 0.02), primarily due to a narrower anteroposterior diameter at this level (p = 0.03). The tongue volume (p = 0.91), lateral pharyngeal wall volume (p = 0.26), tongue length (p = 0.93), soft palate length (p = 0.13), and dynamic change of upper airway with inspiration (p = 0.31) were not significantly different between the two groups.
Conclusions
While the retro-palatal airway is equally narrow in both groups of patients, patients with severe OSA also have a significantly narrower retro-glossal airway. This finding could represent either a generalized reduction in airway area in whole of the oropharynx or multiple-level obstruction; probably aggravating upper airway collapse during sleep, predisposing some Asian obese patients to develop severe OSA.
{"title":"Study of the upper airway anatomy using magnetic resonance imaging in Indian obese patients with obstructive sleep apnea – A pilot study","authors":"Sanjeev Sinha , Bhavesh Mohan Lal , Maskani Nithya , Renuka Titiyal , Soumyadeep Datta , Surabhi Vyas , Sandeep Aggarwal , Brandon Nokes , Atul Malhotra","doi":"10.1016/j.dsx.2024.103169","DOIUrl":"10.1016/j.dsx.2024.103169","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is very common in obese patients. However, why some obese patients have severe OSA while others do not is unclear. Research is limited regarding which structures contribute to upper airway narrowing, especially in Asian patients where bony restrictions is thought to be important.</div></div><div><h3>Methods</h3><div>Nineteen consecutive patients with BMI ≥35 kg/m<sup>2</sup>, and newly diagnosed with OSA based on overnight polysomnography were studied using non-contrast magnetic resonance imaging (MRI) of the upper airway during wakefulness.</div></div><div><h3>Results</h3><div>Patients were divided into two groups, one with severe OSA comprising 11 patients and one without severe OSA having 8 patients. The retro-palatal airway was narrowest in both groups. Patients with severe OSA had a significantly narrower retroglossal airway (0.99 ± 0.48 cm<sup>2</sup> vs 2.61 ± 2.02 cm<sup>2</sup>, p = 0.02), primarily due to a narrower anteroposterior diameter at this level (p = 0.03). The tongue volume (p = 0.91), lateral pharyngeal wall volume (p = 0.26), tongue length (p = 0.93), soft palate length (p = 0.13), and dynamic change of upper airway with inspiration (p = 0.31) were not significantly different between the two groups.</div></div><div><h3>Conclusions</h3><div>While the retro-palatal airway is equally narrow in both groups of patients, patients with severe OSA also have a significantly narrower retro-glossal airway. This finding could represent either a generalized reduction in airway area in whole of the oropharynx or multiple-level obstruction; probably aggravating upper airway collapse during sleep, predisposing some Asian obese patients to develop severe OSA.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 11","pages":"Article 103169"},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796177","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}
Pub Date : 2024-10-01DOI: 10.1016/j.dsx.2024.103138
Yu Huang , Yanjun Zhang , Chun Zhou , Mengyi Liu , Sisi Yang , Hao Xiang , Xiaoqin Gan , Ziliang Ye , Panpan He , Yuanyuan Zhang , Xianhui Qin
Background
We explored the association of dietary manganese (Mn) with new-onset chronic kidney disease (CKD) in participants with diabetes on different glycemia control status and potential mechanisms.
Methods
The study included 7248 adults with diabetes from the UK Biobank who had complete dietary data and were free of CKD at baseline. Dietary information was collected by the online 24-h diet recall questionnaires. The primary outcome was new-onset CKD.
Results
565 (7.8 %) participants developed new-onset CKD during a median follow-up of 11.96 years. Overall, there was a significantly inverse relationship of dietary Mn intake with new-onset CKD in individuals with diabetes at glycated hemoglobin (HbA1c) ≥6.5 % (per SD increment, HR [95%CI]: 0.79 [0.68-0.91]), but not in people with diabetes at HbA1c <6.5 % (per SD increment, HR [95%CI]: 1.07 [0.90-1.29]; P for interaction = 0.004). In individuals with diabetes at HbA1c ≥6.5 %, body mass index and waist circumference significantly mediated the association between dietary Mn intake and new-onset CKD, with mediated proportions of 17.5 % and 17.4 %, respectively.
Conclusions
Higher dietary Mn intake was significantly associated with a lower new-onset CKD risk in participants with diabetes at poor glycemic control status. The inverse association was mainly mediated by obesity. If further confirmed, our findings underscore the importance of maintaining adequate dietary Mn intake for the primary prevention of new-onset CKD in patients with diabetes, especially those with poor glycemic control.
{"title":"Association of dietary manganese intake with new-onset chronic kidney disease in participants with diabetes","authors":"Yu Huang , Yanjun Zhang , Chun Zhou , Mengyi Liu , Sisi Yang , Hao Xiang , Xiaoqin Gan , Ziliang Ye , Panpan He , Yuanyuan Zhang , Xianhui Qin","doi":"10.1016/j.dsx.2024.103138","DOIUrl":"10.1016/j.dsx.2024.103138","url":null,"abstract":"<div><h3>Background</h3><div>We explored the association of dietary manganese (Mn) with new-onset chronic kidney disease (CKD) in participants with diabetes on different glycemia control status and potential mechanisms.</div></div><div><h3>Methods</h3><div>The study included 7248 adults with diabetes from the UK Biobank who had complete dietary data and were free of CKD at baseline. Dietary information was collected by the online 24-h diet recall questionnaires. The primary outcome was new-onset CKD.</div></div><div><h3>Results</h3><div>565 (7.8 %) participants developed new-onset CKD during a median follow-up of 11.96 years. Overall, there was a significantly inverse relationship of dietary Mn intake with new-onset CKD in individuals with diabetes at glycated hemoglobin (HbA1c) ≥6.5 % (per SD increment, HR [95%CI]: 0.79 [0.68-0.91]), but not in people with diabetes at HbA1c <6.5 % (per SD increment, HR [95%CI]: 1.07 [0.90-1.29]; <em>P</em> for interaction = 0.004). In individuals with diabetes at HbA1c ≥6.5 %, body mass index and waist circumference significantly mediated the association between dietary Mn intake and new-onset CKD, with mediated proportions of 17.5 % and 17.4 %, respectively.</div></div><div><h3>Conclusions</h3><div>Higher dietary Mn intake was significantly associated with a lower new-onset CKD risk in participants with diabetes at poor glycemic control status. The inverse association was mainly mediated by obesity. If further confirmed, our findings underscore the importance of maintaining adequate dietary Mn intake for the primary prevention of new-onset CKD in patients with diabetes, especially those with poor glycemic control.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103138"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438111","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}
Pub Date : 2024-10-01DOI: 10.1016/j.dsx.2024.103137
Oana Patricia Zaharia , Klaus Strassburger , Birgit Knebel , Christian Binsch , Yuliya Kupriyanova , Clara Möser , Kálmán Bódis , Katsiaryna Prystupa , Iryna Yurchenko , Dania Marel Mendez Cardenas , Martin Schön , Christian Herder , Hadi Al-Hasani , Vera Schrauwen-Hinderling , Karin Jandeleit-Dahm , Robert Wagner , Michael Roden , GDS Group
Aims
We examined the association of the G allele in the single-nucleotide polymorphism (SNP) rs738409 in the third exon of patatin-like phospholipase domain-containing 3 gene (PNPLA3) gene, with chronic kidney disease in diabetes endotypes.
Methods
Participants with recent-onset diabetes (n = 707) from the prospective German Diabetes Study (GDS) underwent cluster assignment, detailed phenotyping, genotyping and magnetic resonance spectroscopy to quantify hepatocellular lipid content (HCL).
Results
Severe insulin-resistant diabetes (SIRD) had the lowest glomerular filtration rates (eGFR) and highest HCL compared to severe insulin-deficient, moderate obesity-related, moderate age-related and severe autoimmune diabetes endotypes (all p < 0.05). HCL was negatively associated with eGFR (r = −0.287, p < 0.01) across all groups. Stratification by G-allele carrier status did not reveal any association between HCL and eGFR among the endotypes. However, the proportion of G-allele carriers increased from 44 % for eGFR >60 ml/min to 52 % for eGFR <60 ml/min (p < 0.05).
Conclusions
The PNPLA3 polymorphism may contribute to declining kidney function independently of liver lipids.
{"title":"Role of patatin-like phospholipase domain-containing 3 gene for decreasing kidney function in recently diagnosed diabetes mellitus","authors":"Oana Patricia Zaharia , Klaus Strassburger , Birgit Knebel , Christian Binsch , Yuliya Kupriyanova , Clara Möser , Kálmán Bódis , Katsiaryna Prystupa , Iryna Yurchenko , Dania Marel Mendez Cardenas , Martin Schön , Christian Herder , Hadi Al-Hasani , Vera Schrauwen-Hinderling , Karin Jandeleit-Dahm , Robert Wagner , Michael Roden , GDS Group","doi":"10.1016/j.dsx.2024.103137","DOIUrl":"10.1016/j.dsx.2024.103137","url":null,"abstract":"<div><h3>Aims</h3><div>We examined the association of the G allele in the single-nucleotide polymorphism (SNP) rs738409 in the third exon of patatin-like phospholipase domain-containing 3 gene (<em>PNPLA3)</em> gene, with chronic kidney disease in diabetes endotypes.</div></div><div><h3>Methods</h3><div>Participants with recent-onset diabetes (n = 707) from the prospective German Diabetes Study (GDS) underwent cluster assignment, detailed phenotyping, genotyping and magnetic resonance spectroscopy to quantify hepatocellular lipid content (HCL).</div></div><div><h3>Results</h3><div>Severe insulin-resistant diabetes (SIRD) had the lowest glomerular filtration rates (eGFR) and highest HCL compared to severe insulin-deficient, moderate obesity-related, moderate age-related and severe autoimmune diabetes endotypes (all p < 0.05). HCL was negatively associated with eGFR (r = −0.287, p < 0.01) across all groups. Stratification by G-allele carrier status did not reveal any association between HCL and eGFR among the endotypes. However, the proportion of G-allele carriers increased from 44 % for eGFR >60 ml/min to 52 % for eGFR <60 ml/min (p < 0.05).</div></div><div><h3>Conclusions</h3><div>The <em>PNPLA3</em> polymorphism may contribute to declining kidney function independently of liver lipids.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 10","pages":"Article 103137"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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