Journal of Diabetes Investigation最新文献_第7页

Mitochondrial ALDH2 improves ß-cell survival and function against doxorubicin-induced apoptosis by targeting CK2 signaling 线粒体ALDH2通过靶向CK2信号传导，提高ß细胞的存活率和功能，抵御多柔比星诱导的细胞凋亡。

IF 3.2 3区医学 Q1 Medicine

Journal of Diabetes Investigation

Pub Date : 2024-05-07 DOI: 10.1111/jdi.14230

Udayakumar Karunakaran, Eun Yeong Ha, Suma Elumalai, Kyu Chang Won, Jun Sung Moon

Aims

The aim of this study was to better understand how the chemotherapy drug doxorubicin contributes to the development of β-cell dysfunction and to explore its relationship with mitochondrial aldehyde dehydrogenase-2 (ALDH2).

Materials and Methods

In order to investigate this hypothesis, doxorubicin was administered to INS-1 cells, a rat insulinoma cell line, either with or without several target protein activators and inhibitors. ALDH2 activity was detected with a commercial kit and protein levels were determined with western blot. Mitochondrial ROS, membrane potential, and lipid ROS were determined by commercial fluorescent probes. The cell viability was measured by CCK-assay.

Results

Exposure of INS-1 cells to doxorubicin decreased active insulin signaling resulting in elevated ALDH2 degradation, compared with control cells by the induction of acid sphingomyelinase mediated ceramide induction. Further, ceramide induction potentiated doxorubicin induced mitochondrial dysfunction. Treatment with the ALDH2 agonist, ALDA1, blocked doxorubicin-induced acid sphingomyelinase activation which significantly blocked ceramide induction and mitochondrial dysfunction mediated cell death. Treatment with the ALDH2 agonist, ALDA1, stimulated casein kinase-2 (CK2) mediated insulin signaling activation. CK2 silencing neutralized the function of ALDH2 in the doxorubicin treated INS-1 cells.

Conclusions

Mitochondrial ALDH2 activation could inhibit the progression of doxorubicin induced pancreatic β-cell dysfunction by inhibiting the acid sphingomyelinase induction of ceramide, by regulating the activation of CK2 signaling. Our research lays the foundation of ALDH2 activation as a therapeutic target for the precise treatment of chemotherapy drug induced β-cell dysfunction.

目的：本研究旨在更好地了解化疗药物多柔比星是如何导致β细胞功能障碍的，并探讨其与线粒体醛脱氢酶-2（ALDH2）的关系：为了研究这一假说，大鼠胰岛素瘤细胞系 INS-1 细胞在使用或不使用多种靶蛋白激活剂和抑制剂的情况下被注射了多柔比星。用商业试剂盒检测 ALDH2 的活性，并用 Western 印迹法测定蛋白水平。线粒体 ROS、膜电位和脂质 ROS 由商用荧光探针测定。细胞活力用 CCK 分析法测定：结果：与对照细胞相比，INS-1细胞暴露于多柔比星后，胰岛素信号传导活性降低，导致ALDH2降解增加，酸性鞘磷脂酶介导的神经酰胺诱导也随之降低。此外，神经酰胺诱导增强了多柔比星诱导的线粒体功能障碍。用 ALDH2 激动剂 ALDA1 治疗可阻止多柔比星诱导的酸性鞘磷脂酶活化，从而显著阻止神经酰胺诱导和线粒体功能障碍介导的细胞死亡。ALDH2 激动剂 ALDA1 可刺激酪蛋白激酶-2（CK2）介导的胰岛素信号激活。在多柔比星处理的 INS-1 细胞中，CK2 沉默中和了 ALDH2 的功能：结论：线粒体 ALDH2 的激活可通过调节 CK2 信号的激活，抑制酸性鞘磷脂酶对神经酰胺的诱导，从而抑制多柔比星诱导的胰岛β细胞功能障碍的进展。我们的研究为将 ALDH2 激活作为精确治疗化疗药物诱导的 β 细胞功能障碍的治疗靶点奠定了基础。

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引用次数: 0

Internet of things-based approach for glycemic control in people with type 2 diabetes: A randomized controlled trial 基于物联网的 2 型糖尿病患者血糖控制方法：随机对照试验

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-05-07 DOI: 10.1111/jdi.14227

Ryotaro Bouchi, Kazuo Izumi, Naoki Ishizuka, Yukari Uemura, Hiroshi Ohtsu, Kengo Miyo, Shigeho Tanaka, Noriko Satoh-Asahara, Kazuo Hara, Masato Odawara, Yoshiki Kusunoki, Hidenori Koyama, Takeshi Onoue, Hiroshi Arima, Kazuyo Tsushita, Hirotaka Watada, Takashi Kadowaki, Kohjiro Ueki

Aims

The utilization of long-term effect of internet of things (IoT) on glycemic control is controversial. This trial aimed to examine the effect of an IoT-based approach for type 2 diabetes.

Materials and Methods

This randomized controlled trial enrolled 1,159 adults aged 20–74 years with type 2 diabetes with a HbA1c of 6.0–8.9% (42–74 mmol/mol), who were using a smartphone on a daily basis were randomly assigned to either the IoT-based approach group (ITG) or the control group (CTG). The ITG were supervised to utilize an IoT automated system that demonstrates a summary of lifelogging data (weight, blood pressure, and physical activities) and provides feedback messages that promote behavioral changes in both diet and exercise. The primary end point was a HbA1c change over 52 weeks.

Results

Among the patients, 581 were assigned to the ITG and 578 were in the CTG. The changes in HbA1c from baseline to the final measurement at 52 weeks [mean (standard deviation)] were −0.000 (0.6225)% in ITG and − 0.006 (0.6449)% in CTG, respectively (P = 0.8766). In the per protocol set, including ITG using the IoT system almost daily and CTG, excluding those using the application almost daily, the difference in HbA1c from baseline to 52 weeks were −0.098 (0.579)% and 0.027 (0.571)%, respectively (P = 0.0201). We observed no significant difference in the adverse event profile between the groups.

Conclusions

The IoT-based approach did not reduce HbA1c in patients with type 2 diabetes. IoT-based intervention using data on the daily glycemic control and HbA1c level may be required to improve glycemic control.

目的：利用物联网（IoT）对血糖控制的长期影响还存在争议。本试验旨在研究基于物联网的方法对 2 型糖尿病的影响：这项随机对照试验招募了1159名年龄在20-74岁之间、HbA1c为6.0-8.9%（42-74 mmol/mol）、每天使用智能手机的2型糖尿病患者，将他们随机分配到物联网方法组（ITG）或对照组（CTG）。ITG组在监督下使用物联网自动系统，该系统可显示生活日志数据（体重、血压和体力活动）摘要，并提供反馈信息，促进饮食和运动方面的行为改变。主要终点是 52 周内 HbA1c 的变化：在患者中，581 人被分配到 ITG，578 人被分配到 CTG。从基线到52周最终测量值的HbA1c变化[平均值（标准差）]分别为：ITG为-0.000 (0.6225)%，CTG为- 0.006 (0.6449)%（P = 0.8766）。在按方案组中，包括几乎每天使用物联网系统的 ITG 和不包括几乎每天使用应用程序的 CTG，从基线到 52 周的 HbA1c 差异分别为-0.098 (0.579)% 和 0.027 (0.571)% (P = 0.0201)。我们观察到两组的不良反应情况无明显差异：结论：基于物联网的方法并未降低 2 型糖尿病患者的 HbA1c。可能需要利用日常血糖控制和 HbA1c 水平数据进行基于物联网的干预，以改善血糖控制。

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引用次数: 0

PIONEER REAL Japan: Baseline characteristics of a multicenter, prospective, real-world study of oral semaglutide in adults with type 2 diabetes in clinical practice in Japan 日本 PIONEER REAL：一项针对日本临床实践中 2 型糖尿病成人患者口服塞马鲁肽的多中心、前瞻性、真实世界研究的基线特征。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-05-06 DOI: 10.1111/jdi.14219

Ryo Suzuki, Hanan Amadid, Atheline Major-Pedersen, Daisuke Yabe

Aims/Introduction

PIONEER REAL Japan was a non-interventional, multicenter, prospective study investigating oral semaglutide in adults with type 2 diabetes in routine clinical practice. We report baseline characteristics of participants enrolled in this study.

Materials and Methods

Adults aged ≥20 years with type 2 diabetes but no previous treatment with injectable glucose-lowering medication were enrolled. Participants initiated oral semaglutide at their treating physician's discretion and were followed for 34–44 weeks. Participants were stratified into <75-year-old and ≥75-year-old subgroups.

Results

A total of 624 participants initiated the study. The mean (standard deviation) age was 64.1 years (14.1), the mean (standard deviation) body weight was 72.4 kg (16.1), and the mean (standard deviation) body mass index was 27.5 kg/m² (5.0). Participants had a median (interquartile range) type 2 diabetes duration of 9.3 years (4.2, 15.2) and mean (standard deviation) glycated hemoglobin 7.7% (1.1). Most (75.6%) participants were taking glucose-lowering medications at baseline; the most common was metformin (51.9%). The main reasons for initiating oral semaglutide were glycemic control and weight loss. Most (86.0%) participants had an individualized target for glycemic control of glycated hemoglobin ≤7%. The <75-year-old subgroup was heavier (mean [standard deviation] body mass index 28.6 kg/m² [5.2] vs 25.1 kg/m² [3.4]) but had comparable glycated hemoglobin levels (mean [standard deviation] 7.7% [1.2] vs 7.8% [1.0]) to the ≥75-year-old subgroup.

Conclusions

PIONEER REAL Japan describes the characteristics of individuals with type 2 diabetes prescribed oral semaglutide. The baseline characteristics provide insights into Japanese individuals with type 2 diabetes prescribed oral semaglutide in clinical practice.

目的/简介：日本 PIONEER REAL 是一项非干预性、多中心、前瞻性研究，旨在调查常规临床实践中成人 2 型糖尿病患者口服塞马鲁肽的情况。我们报告了这项研究参与者的基线特征：研究对象为年龄≥20 岁、患有 2 型糖尿病但之前未接受过注射降糖药物治疗的成人。参与者根据主治医生的决定开始口服塞马鲁肽，并接受 34-44 周的随访。研究结果共有 624 名参与者开始了研究。平均（标准差）年龄为 64.1 岁（14.1），平均（标准差）体重为 72.4 公斤（16.1），平均（标准差）体重指数为 27.5 公斤/平方米（5.0）。参与者的 2 型糖尿病病程中位数（四分位数间距）为 9.3 年（4.2，15.2），糖化血红蛋白平均值（标准差）为 7.7% (1.1)。大多数参与者（75.6%）在基线时正在服用降糖药物，其中最常见的是二甲双胍（51.9%）。开始口服塞马鲁肽的主要原因是控制血糖和减轻体重。大多数参与者（86.0%）的个体化血糖控制目标是糖化血红蛋白≤7%。但糖化血红蛋白水平（平均值 [标准差] 7.7% [1.2] vs 7.8% [1.0]）与≥75 岁亚组相当：PIONEER REAL Japan描述了口服塞马鲁肽的2型糖尿病患者的特征。结论：PIONEER REAL Japan描述了口服塞马鲁肽的2型糖尿病患者的特征，其基线特征有助于了解日本2型糖尿病患者在临床实践中口服塞马鲁肽的情况。

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引用次数: 0

A multicenter, open-label, single-arm trial of the long-term safety of empagliflozin treatment for refractory diabetes mellitus with insulin resistance (EMPIRE-02) 一项关于恩格列净治疗难治性糖尿病合并胰岛素抵抗的长期安全性的多中心、开放标签、单臂试验（EMPIRE-02）

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-05-04 DOI: 10.1111/jdi.14226

Yushi Hirota, Yasumasa Kakei, Junta Imai, Hideki Katagiri, Ken Ebihara, Jun Wada, Junichi Suzuki, Tatsuhiko Urakami, Takashi Omori, Wataru Ogawa

Aims/Introduction

Insulin resistance syndrome and lipoatrophic diabetes are rare conditions characterized by the development of treatment-refractory diabetes with severe insulin resistance. We recently conducted a 24 week, multicenter, single-arm trial (EMPIRE-01) that demonstrated a certain level of effectiveness and safety of empagliflozin for these conditions. To evaluate treatment safety over a longer period, we have now performed an additional 28 week trial (EMPIRE-02) that followed on from EMPIRE-01.

Materials and Methods

The primary and secondary outcomes were safety and efficacy evaluations, respectively. All eight subjects of the EMPIRE-01 trial participated in EMPIRE-02.

Results

Twenty adverse events (AEs) were recorded among five individuals during the combined 52 week treatment period of both trials. Whereas one case of chronic hepatitis B was moderate in severity, all other AEs were mild. There were thus no serious AEs or events necessitating discontinuation or suspension of treatment or a reduction in drug dose. Whereas ketoacidosis or marked increases in serum ketone body levels were not observed, the mean body mass of the subjects was decreased slightly after completion of EMPIRE-02. The improvement in mean values of glycemic parameters observed in EMPIRE-01 was not sustained in EMPIRE-02, mostly because of one individual whose parameters deteriorated markedly, likely as a result of nonadherence to diet therapy. The improvement in glycemic parameters was sustained during EMPIRE-02 after exclusion of this subject from analysis.

Conclusions

Empagliflozin demonstrated a certain level of safety and efficacy for the treatment of insulin resistance syndrome and lipoatrophic diabetes over 52 weeks, confirming its potential as a therapeutic option.

目的/简介胰岛素抵抗综合征和脂肪滋养型糖尿病是一种罕见的疾病，其特点是出现严重胰岛素抵抗的难治性糖尿病。我们最近进行了一项为期24周的多中心单臂试验（EMPIRE-01），结果表明empagliflozin对这些病症具有一定的有效性和安全性。为了评估更长期的治疗安全性，我们在 EMPIRE-01 试验的基础上又进行了一项为期 28 周的试验（EMPIRE-02）。EMPIRE-01 试验的所有 8 名受试者都参加了 EMPIRE-02 试验。结果在两项试验的 52 周治疗期间，共有 5 人发生了 20 起不良事件（AEs）。其中一例慢性乙型肝炎的严重程度为中度，其他所有不良反应均为轻度。因此，没有出现严重的 AE 或需要中断或暂停治疗或减少药物剂量的事件。虽然没有观察到酮症酸中毒或血清酮体水平明显升高的情况，但在完成 EMPIRE-02 治疗后，受试者的平均体重略有下降。在 EMPIRE-01 中观察到的血糖参数平均值的改善在 EMPIRE-02 中并没有持续，主要原因是有一个人的血糖参数明显恶化，这可能是不坚持饮食治疗的结果。结论Empagliflozin在治疗胰岛素抵抗综合征和脂肪变性糖尿病方面具有一定的安全性和有效性，疗程长达52周，证实了其作为一种治疗选择的潜力。

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引用次数: 0

Efficacy and tolerability of oral semaglutide in Japanese patients with type 2 diabetes mellitus: Analysis report from diabetes specialist clinics 日本 2 型糖尿病患者口服塞马鲁肽的疗效和耐受性：糖尿病专科诊所的分析报告

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-05-03 DOI: 10.1111/jdi.14225

Tetsuaki Inokuchi, Yoshihide Fukumoto, Gendai Lee, Yoshifumi Yokomizo, Kokichi Tanaka, Michiko Chosa, Masaru Doi, Noboru Tamaki, Seiichi Goto, Kojiro Ichikawa, Kazuo Kobayashi

Introduction

Glucagon-like peptide 1 receptor agonists (GLP1Ras) have emerged as pivotal agents in diabetes management and organ protection. However, their use is limited due to the necessity for injectable administration. The advent of the first oral GLP1Ra (oral semaglutide) in Japan since 2021 is expected to expand its usage. The aim of this study is to survey the efficacy and tolerability of oral semaglutide in clinical practice.

Materials and Methods

We retrospectively analyzed 120 outpatients diagnosed with type 2 diabetes mellitus who had received oral semaglutide for >6 months. Changes in clinical parameters during oral semaglutide treatment from baseline to 12 months were analyzed. The inverse probability weighting method using the propensity score was used to evaluate the differences in clinical parameters at 6 months after treatment, based on the patients’ obesity levels.

Results

Body weight (BW), glycated hemoglobin A_1c (HbA_1c), and alanine aminotransferase (ALT) levels at baseline decreased significantly after treatment compared with those at 12 months (P < 0.001, P < 0.001, and P = 0.03, respectively). The patients were divided into two groups using a cutoff baseline body mass index (BMI) of 30.3 kg/m². Although no significant difference was observed, changes in body weight and HbA_1c indicated a potentially greater decrease in the BMI ≧ 30.3 group than that in the BMI < 30.3 group (P = 0.07 and 0.13, respectively). Among 206 registered patients, 25 (12.1%) discontinued oral-semaglutide treatment owing to adverse effects, including gastrointestinal symptoms.

Conclusions

Oral semaglutide treatment demonstrates efficacy and tolerability for managing type 2 diabetes mellitus in Japan. Significant improvements in metabolic factors induced by oral semaglutide are anticipated, particularly in obese patients.

导言胰高血糖素样肽 1 受体激动剂（GLP1Ras）已成为糖尿病管理和器官保护的关键药物。然而，由于必须注射给药，它们的使用受到了限制。自 2021 年起，日本出现了第一种口服 GLP1Ra（口服塞马鲁肽），有望扩大其使用范围。本研究的目的是调查口服塞马鲁肽在临床实践中的疗效和耐受性。材料与方法我们回顾性分析了120名门诊确诊的2型糖尿病患者，他们接受口服塞马鲁肽治疗>6个月。分析了口服塞马鲁肽治疗期间临床指标从基线到12个月的变化。结果基线时的体重（BW）、糖化血红蛋白A1c（HbA1c）和丙氨酸氨基转移酶（ALT）水平在治疗后与12个月时相比显著下降（分别为P <0.001、P <0.001和P = 0.03）。以基线体重指数（BMI）为 30.3 kg/m2 为临界值，将患者分为两组。虽然没有观察到明显差异，但体重和 HbA1c 的变化表明，BMI ≧ 30.3 组比 BMI < 30.3 组的下降幅度可能更大（P = 0.07 和 0.13）。在 206 名登记患者中，有 25 人（12.1%）因胃肠道症状等不良反应而中断了口服塞马鲁肽的治疗。预计口服塞马鲁肽可显著改善代谢因素，尤其是肥胖患者。

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引用次数: 0

Glycemic variability is associated with sural nerve conduction velocity in outpatients with type 2 diabetes: Usefulness of a new point-of-care device for nerve conduction studies 2 型糖尿病门诊患者的血糖变化与鞍神经传导速度有关：用于神经传导研究的新型护理点设备的实用性

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-04-29 DOI: 10.1111/jdi.14211

Machiko Morita, Kentaro Sada, Shuji Hidaka, Miki Ogawa, Hirotaka Shibata

Aims/Introduction

Although several studies have shown the association between continuous glucose monitoring (CGM)-derived glycemic variability (GV) and diabetic peripheral neuropathy, no studies have focused on outpatients or used NC-stat®/DPNCheck™, a new point-of-care device for nerve conduction study (NCS). We investigated the association between CGM-derived GV and NCS using DPNCheck™ in outpatients with type 2 diabetes, and further analyzed the difference in results between patients with and without well-controlled HbA1c levels.

Materials and Methods

All outpatients with type 2 diabetes using the CGM device (FreeStyle Libre Pro®) between 2017 and 2022 were investigated. Sural nerve conduction was evaluated by sensory nerve action potential (SNAP) amplitude and sensory conduction velocity (SCV) using DPNCheck™. Associations of CGM-derived GV metrics with SNAP amplitude and SCV were investigated.

Results

In total, 304 outpatients with type 2 diabetes were included. In a linear regression model, most CGM-derived GV metrics except for the mean amplitude of glucose excursion and low blood glucose index were significantly associated with SCV, but not with SNAP amplitude. The significant associations of most CGM-derived GV metrics with SCV remained after adjustment for possible confounding factors, but not after adjustment for glycated hemoglobin (HbA1c). Most CGM-derived GV metrics were significantly associated with SCV after adjustment for HbA1c in patients with a HbA1c ≤ 6.9%, but not in those with a HbA1c ≥ 7.0%.

Conclusions

In outpatients with type 2 diabetes, multiple CGM-derived GV metrics were significantly associated with SCV obtained by DPNCheck™. GV may have independent impacts on peripheral nerve function, particularly in patients with well-controlled HbA1c levels.

目的/引言尽管多项研究显示连续血糖监测（CGM）得出的血糖变异性（GV）与糖尿病周围神经病变之间存在关联，但没有研究关注门诊患者或使用 NC-stat®/DPNCheck™（一种用于神经传导研究（NCS）的新型护理点设备）。我们调查了 2 型糖尿病门诊患者使用 DPNCheck™ 进行 CGM 导出的 GV 与 NCS 之间的关联，并进一步分析了 HbA1c 水平控制良好的患者与未控制良好的患者之间的结果差异。材料与方法调查了 2017 年至 2022 年期间使用 CGM 设备（FreeStyle Libre Pro®）的所有 2 型糖尿病门诊患者。使用 DPNCheck™ 通过感觉神经动作电位（SNAP）振幅和感觉传导速度（SCV）评估耳神经传导。结果共纳入 304 名门诊 2 型糖尿病患者。在线性回归模型中，除葡萄糖偏移的平均振幅和低血糖指数外，大多数 CGM 导出的 GV 指标与 SCV 显著相关，但与 SNAP 振幅无关。在对可能的混杂因素进行调整后，大多数 CGM 导出的 GV 指标与 SCV 仍有明显的相关性，但在对糖化血红蛋白 (HbA1c) 进行调整后则没有。在调整 HbA1c ≤ 6.9% 患者的 HbA1c 后，大多数 CGM 导出的 GV 指标与 SCV 显著相关，但在调整 HbA1c ≥ 7.0% 患者的 HbA1c 后，大多数 CGM 导出的 GV 指标与 SCV 无关。GV 可能对周围神经功能有独立影响，尤其是在 HbA1c 控制良好的患者中。

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引用次数: 0

Optimizing lipid control in Taiwanese diabetic patients: A collaborative consensus by the Diabetes Association of the Republic of China (Taiwan) and the Taiwanese Association of Diabetes Educators 优化台湾糖尿病患者的血脂控制：中华民国（台湾）糖尿病协会与台湾糖尿病教育工作者协会的合作共识

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-04-27 DOI: 10.1111/jdi.14222

Feng-Chih Shen, Chih-Hsun Chu, Jung-Fu Chen, Chin-Sung Kuo, Chih-Yao Hsu, Ching-Han Lin, Yi-Jing Sheen, Sheng-Chiang Su, Kai-Jen Tien, Chieh-Hua Lu, Chun-Chuan Lee, Yi-Sun Yang, Shih-Te Tu, Po-Tsang Chen, Ching-Chu Chen, Ming-Nan Chien, Hung-Yuan Li, Wayne Huey-Herng Sheu, Chien-Ning Huang, Chih-Yuan Wang, Horng-Yih Ou

We present an in-depth analysis of dyslipidemia management strategies for patients with diabetes mellitus in Taiwan. It critically examines the disparity between established guideline recommendations and actual clinical practices, particularly in the context of evolving policies affecting statin prescriptions. The focus is on synthesizing the most recent findings concerning lipid management in patients with diabetes mellitus, with a special emphasis on establishing consensus regarding low-density lipoprotein cholesterol treatment targets. The article culminates in providing comprehensive, evidence-based recommendations tailored to the unique needs of those living with diabetes mellitus in Taiwan. It underscores the criticality of personalized care approaches, which incorporate multifaceted factors, and the integration of novel therapeutic options to enhance cardiovascular health outcomes.

我们对台湾糖尿病患者的血脂异常管理策略进行了深入分析。它批判性地审视了既定指南建议与实际临床实践之间的差异，尤其是在影响他汀类药物处方的政策不断演变的背景下。文章重点综述了有关糖尿病患者血脂管理的最新研究成果，并特别强调要就低密度脂蛋白胆固醇的治疗目标达成共识。文章最后针对台湾糖尿病患者的独特需求，提出了全面的循证建议。文章强调了结合多方面因素的个性化护理方法的重要性，以及整合新型治疗方案以提高心血管健康成果的重要性。

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引用次数: 0

Pancreatic beta-cell mass and function and therapeutic implications of using antidiabetic medications in type 2 diabetes 2 型糖尿病患者胰腺 beta 细胞的质量和功能以及使用抗糖尿病药物的治疗意义

IF 3.2 3区医学 Q1 Medicine

Journal of Diabetes Investigation

Pub Date : 2024-04-27 DOI: 10.1111/jdi.14221

Joon Ho Moon, Hun Jee Choe, Soo Lim

Nowadays, the focus of diabetes treatment has switched from lowering the glucose level to preserving glycemic homeostasis and slowing the disease progression. The main pathophysiology of both type 1 diabetes and long-standing type 2 diabetes is pancreatic β-cell mass loss and dysfunction. According to recent research, human pancreatic β-cells possess the ability to proliferate in response to elevated insulin demands. It has been demonstrated that in insulin-resistant conditions in humans, such as obesity or pregnancy, the β-cell mass increases. This ability could be helpful in developing novel treatment approaches to restore a functional β-cell mass. Treatment strategies aimed at boosting β-cell function and mass may be a useful tool for managing diabetes mellitus and stopping its progression. This review outlines the processes of β-cell failure and detail the many β-cell abnormalities that manifest in people with diabetes mellitus. We also go over standard techniques for determining the mass and function of β-cells. Lastly, we provide the therapeutic implications of utilizing antidiabetic drugs in controlling the mass and function of pancreatic β-cells.

如今，糖尿病治疗的重点已从降低血糖水平转向维持血糖平衡和延缓疾病进展。无论是1型糖尿病还是久治不愈的2型糖尿病，其主要病理生理机制都是胰岛β细胞大量丢失和功能障碍。最新研究表明，人类胰岛β细胞具有增殖能力，以应对胰岛素需求的增加。研究表明，在肥胖或妊娠等人体胰岛素抵抗的情况下，β细胞质量会增加。这种能力有助于开发新型治疗方法，以恢复功能性β细胞质量。旨在增强β细胞功能和质量的治疗策略可能是控制糖尿病和阻止其恶化的有用工具。本综述概述了β细胞功能衰竭的过程，并详细介绍了糖尿病患者体内出现的多种β细胞异常。我们还将介绍测定 β 细胞质量和功能的标准技术。最后，我们将介绍使用抗糖尿病药物控制胰岛β细胞质量和功能的治疗意义。

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引用次数: 0

Possible etiological role of impaired endogenous double strand RNA editing in β-cells in type 1 diabetes 1 型糖尿病患者β细胞中内源性双链 RNA 编辑功能受损的可能病因。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-04-25 DOI: 10.1111/jdi.14224

Junta Imai

Proposed mechanisms by which disruption of endogenous dsRNA editing in β-cells leads to type 1 diabetes-like phenotypes in βAdarKO mice. Disruption of endogenous dsRNA editing in β-cells initiates IFN responses, thereby inducing pancreatic islet inflammation and β-cell dysfunction. Hyperglycemia induced by β-cell dysfunction further promotes islet inflammation, likely via increased dsRNA resulting from increased β-cell workload, thereby producing a vicious cycle. The mechanism by which impairment of dsRNA editing is integrated with autoimmune-mediated pathogenesis of type 1 diabetes remains to be clarified.

破坏β细胞内源性dsRNA编辑导致βAdarKO小鼠出现1型糖尿病样表型的拟议机制。β细胞内源性dsRNA编辑的中断会引发IFN反应，从而诱发胰岛炎症和β细胞功能障碍。由 β 细胞功能障碍诱发的高血糖进一步促进了胰岛炎症，这可能是由于 β 细胞工作量增加导致 dsRNA 增加，从而产生了恶性循环。dsRNA编辑障碍与自身免疫介导的1型糖尿病发病机制的结合机制仍有待明确。

引用次数: 0

Association between variation in hemoglobin A1c levels and diabetes therapy-related quality of life in patients with diabetes 糖尿病患者血红蛋白 A1c 水平变化与糖尿病治疗相关生活质量之间的关系。

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation

Pub Date : 2024-04-24 DOI: 10.1111/jdi.14218

Dan Imai, Emi Ushigome, Ryosuke Sakai, Noriyuki Kitagawa, Masahide Hamaguchi, Masahiro Yamazaki, Michiaki Fukui

Aims/Introduction

We aimed to investigate the association between glycemic variability and quality of life (QOL) in patients with diabetes, which has not been studied previously.

Materials and Methods

Patients who were undergoing treatment at the Kyoto Prefectural University of Medicine Hospital and Kameoka City Hospital participated in the KAMOGAWA-DM study, and completed the diabetes therapy-related (DTR)-QOL questionnaire from January 2016 to July 2020 were included in this study. We used linear regression analyses to compare the association between DTR-QOL scores and glycemic variability.

Results

We included a total of 635 patients in this analysis. The hemoglobin A1c (HbA1c) levels of these patients were measured at least four times during the 9-month period, before and after answering the questionnaire. Results showed that HbA1c variability, HbA1c mean and duration of diabetes were negatively associated with the total DTR-QOL score. Conversely, the body mass index and total DTR-QOL score were positively associated with HbA1c variability.

Conclusions

A small variation in HbA1c level was associated with higher total DTR-QOL scores and the scores for each factor. Reducing blood glucose variability is significant when we treat diabetes.

材料与方法参与 KAMOGAWA-DM 研究并在 2016 年 1 月至 2020 年 7 月期间填写糖尿病治疗相关（DTR）-QOL 问卷的京都府立医科大学附属医院和龟冈市立医院接受治疗的患者被纳入本研究。我们使用线性回归分析比较了 DTR-QOL 评分与血糖变化之间的关联。这些患者的血红蛋白 A1c（HbA1c）水平在 9 个月的时间内至少测量了 4 次，分别在回答问卷前后进行。结果显示，HbA1c 变异性、HbA1c 平均值和糖尿病持续时间与 DTR-QOL 总分呈负相关。相反，体重指数和 DTR-QOL 总分与 HbA1c 变异性呈正相关。在治疗糖尿病时，降低血糖变异性意义重大。

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引用次数: 0