Pub Date : 2025-01-24DOI: 10.1016/j.deman.2025.100258
Andrew Kanouse , Joanna S. Fishbein , Parissa Salemi
Aim
The prevalence of type 2 diabetes continues to rise across multiple demographics but there was an especially large increase in incidence during the COVID-19 pandemic. A pre-existing diagnosis of type 2 diabetes is generally associated with more difficulties with viral infections, as seen with COVID-19, but it is less clear if a reverse causal association exists between the development of type 2 diabetes and infection with the COVID-19 virus. Our aim was to determine if an association exists between the COVID-19 virus and new diagnoses of pediatric type 2 diabetes.
Methods
We examined 130 new patients in our pediatric endocrinology practice diagnosed with type 2 diabetes immediately before and just after the emergence of the pandemic to determine if there was a change in presenting characteristics between these two periods.
Results
Our data showed an increase in the incidence of type 2 diabetes (p < 0.0001) and a lower mean presenting age (p = 0.03) during the COVID-19 pandemic without differences in other parameters.
Conclusion
We believe these results suggest that the development of type 2 diabetes following COVID-19 infection is due to mechanisms inherent to the virus itself and that younger patients are especially at an increased risk.
{"title":"The rise in incidence of pediatric type 2 diabetes during the COVID-19 pandemic and the virus as a potential causative factor","authors":"Andrew Kanouse , Joanna S. Fishbein , Parissa Salemi","doi":"10.1016/j.deman.2025.100258","DOIUrl":"10.1016/j.deman.2025.100258","url":null,"abstract":"<div><h3>Aim</h3><div>The prevalence of type 2 diabetes continues to rise across multiple demographics but there was an especially large increase in incidence during the COVID-19 pandemic. A pre-existing diagnosis of type 2 diabetes is generally associated with more difficulties with viral infections, as seen with COVID-19, but it is less clear if a reverse causal association exists between the development of type 2 diabetes and infection with the COVID-19 virus. Our aim was to determine if an association exists between the COVID-19 virus and new diagnoses of pediatric type 2 diabetes.</div></div><div><h3>Methods</h3><div>We examined 130 new patients in our pediatric endocrinology practice diagnosed with type 2 diabetes immediately before and just after the emergence of the pandemic to determine if there was a change in presenting characteristics between these two periods.</div></div><div><h3>Results</h3><div>Our data showed an increase in the incidence of type 2 diabetes (<em>p</em> < 0.0001) and a lower mean presenting age (<em>p</em> = 0.03) during the COVID-19 pandemic without differences in other parameters.</div></div><div><h3>Conclusion</h3><div>We believe these results suggest that the development of type 2 diabetes following COVID-19 infection is due to mechanisms inherent to the virus itself and that younger patients are especially at an increased risk.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"18 ","pages":"Article 100258"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128747","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}
Diabetes-related sarcopenia is a significant contributor to the global prevalence of sarcopenia. Both conditions become more prevalent with age and amplify the risk of adverse outcomes. This study aimed to assess the prevalence of sarcopenia and at-risk morphofunctional (MF) phenotypes and to identify the factors associated in patients with type 2 diabetes (T2D), including non-elderly adults, in primary care settings
Methods
This cross-sectional study included 261 individuals managed in primary care units in Mexico City, between July 2022 and May 2024. Assessments followed the guidelines of the European Working Group on Sarcopenia in Older Adults (EWGSOP2) to identify isolated low muscle mass, low muscle strength, and sarcopenia or severe sarcopenia
Results
The mean age of the participants (57.1 % female) was 51.1 ± 12.1 years, with a median diabetes duration of 7 (1–15) years. An altered MF assessment was observed in 159 participants, with 14.1 % exhibiting sarcopenia, 5.4 % isolated low muscle strength, and 41.4 % isolated low muscle mass. Univariate logistic regression analysis identified that age, educational level, diabetes duration, weight, body mass index, waist circumference, hip circumference, fat mass, use, and insulin dose were associated with altered MF assessment. Multivariable analyses showed that hip circumference and hypertriglyceridemia were associated with a lower risk of altered MF assessment, whereas the interactions between age and fat mass increased the risk.
Conclusions
This primary care study, which included elderly and non-elderly adults with T2D, revealed a relatively high prevalence of altered MF assessments, including sarcopenia, low muscle strength, and low muscle mass. Early recognition of sarcopenia spectrum disorders is essential for the timely prevention of adverse outcomes related to diabetic sarcopenia in primary care settings.
{"title":"Prevalence of diabetes-related sarcopenia and its defining components within primary care: A cross-sectional study","authors":"Rubén Silva-Tinoco , Lilia Castillo-Martínez , Berenice Cabrera-Victoria , Eileen Guzmán-Olvera , Christian Hinojosa-Segura , Alejandro Avalos-Bracho , Cira Santillán-Díaz","doi":"10.1016/j.deman.2025.100252","DOIUrl":"10.1016/j.deman.2025.100252","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes-related sarcopenia is a significant contributor to the global prevalence of sarcopenia. Both conditions become more prevalent with age and amplify the risk of adverse outcomes. This study aimed to assess the prevalence of sarcopenia and at-risk morphofunctional (MF) phenotypes and to identify the factors associated in patients with type 2 diabetes (T2D), including non-elderly adults, in primary care settings</div></div><div><h3>Methods</h3><div>This cross-sectional study included 261 individuals managed in primary care units in Mexico City, between July 2022 and May 2024. Assessments followed the guidelines of the European Working Group on Sarcopenia in Older Adults (EWGSOP2) to identify isolated low muscle mass, low muscle strength, and sarcopenia or severe sarcopenia</div></div><div><h3>Results</h3><div>The mean age of the participants (57.1 % female) was 51.1 ± 12.1 years, with a median diabetes duration of 7 (1–15) years. An altered MF assessment was observed in 159 participants, with 14.1 % exhibiting sarcopenia, 5.4 % isolated low muscle strength, and 41.4 % isolated low muscle mass. Univariate logistic regression analysis identified that age, educational level, diabetes duration, weight, body mass index, waist circumference, hip circumference, fat mass, use, and insulin dose were associated with altered MF assessment. Multivariable analyses showed that hip circumference and hypertriglyceridemia were associated with a lower risk of altered MF assessment, whereas the interactions between age and fat mass increased the risk.</div></div><div><h3>Conclusions</h3><div>This primary care study, which included elderly and non-elderly adults with T2D, revealed a relatively high prevalence of altered MF assessments, including sarcopenia, low muscle strength, and low muscle mass. Early recognition of sarcopenia spectrum disorders is essential for the timely prevention of adverse outcomes related to diabetic sarcopenia in primary care settings.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"18 ","pages":"Article 100252"},"PeriodicalIF":1.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128746","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 : 2025-01-01DOI: 10.1016/j.deman.2024.100248
Sanaa Mekdad, Leenah Alsayed, Susan Alkhulaif
Introduction
Globally, diabetes is becoming an increasingly prevalent chronic illness. Managing glucose levels in patients with diabetes presents a significant challenge that requires collaboration with medical specialists. Clinical pharmacists play a crucial role in diabetes management, positively influencing patient outcomes and improving overall quality of care.
Objectives
The purpose of this research is to understand how clinical pharmacists at King Fahad Medical City impact the management of hospitalized patients with diabetes and cardiac conditions.
Method
A prospective randomized study was conducted at the Cardiac Center of King Fahad Medical City, involving patients admitted between 2019 and 2023. Participants were assigned to one of two groups: one managed by clinical pharmacists (n = 500) and the other receiving standard care without clinical pharmacists (n = 500). Patients were followed up with six months following the clinical pharmacist's intervention, as well as concurrently with data collection, baseline measurements of glycosylated hemoglobin (HbAC), fasting blood glucose (FBG), and the frequency of hypoglycemic episodes. after intervention. Concurrently, included (HbA1c), after intervention. Concurrently, collection included (HbA1c), episodes following the
Results
Both groups demonstrated a decrease in HbA1c levels. The intervention group experienced a reduction in HbA1c from 10.2 % to 8.5 % (SD = 2.2, p = 0.04). In contrast, the control group showed a decrease in HbA1c from 9.95 % to 9.05 % (SD = 1.95, p = 0.05). Additionally, fasting blood glucose (FBG) levels in the intervention group decreased by 29 mg/dL, while the decline in the control group was not statistically significant, at 9 mg/dL. The difference in HbA1c levels was statistically significant, as determined by both t-tests.
Conclusions
As a member of a multidisciplinary team, a clinical pharmacist can play a crucial role in monitoring diabetes in hospitalized patients with heart conditions. Their interventions can more effectively lower HbA1c levels and fasting blood glucose (FBG) in these patients compared to standard care.
{"title":"The role of clinical pharmacists in improving diabetic care of hospitalized heart patients","authors":"Sanaa Mekdad, Leenah Alsayed, Susan Alkhulaif","doi":"10.1016/j.deman.2024.100248","DOIUrl":"10.1016/j.deman.2024.100248","url":null,"abstract":"<div><h3>Introduction</h3><div>Globally, diabetes is becoming an increasingly prevalent chronic illness. Managing glucose levels in patients with diabetes presents a significant challenge that requires collaboration with medical specialists. Clinical pharmacists play a crucial role in diabetes management, positively influencing patient outcomes and improving overall quality of care.</div></div><div><h3>Objectives</h3><div>The purpose of this research is to understand how clinical pharmacists at King Fahad Medical City impact the management of hospitalized patients with diabetes and cardiac conditions.</div></div><div><h3>Method</h3><div>A prospective randomized study was conducted at the Cardiac Center of King Fahad Medical City, involving patients admitted between 2019 and 2023. Participants were assigned to one of two groups: one managed by clinical pharmacists (<em>n</em> = 500) and the other receiving standard care without clinical pharmacists (<em>n</em> = 500). Patients were followed up with six months following the clinical pharmacist's intervention, as well as concurrently with data collection, baseline measurements of glycosylated hemoglobin (HbAC), fasting blood glucose (FBG), and the frequency of hypoglycemic episodes. after intervention. Concurrently, included (HbA1c), after intervention. Concurrently, collection included (HbA1c), episodes following the</div></div><div><h3>Results</h3><div>Both groups demonstrated a decrease in HbA1c levels. The intervention group experienced a reduction in HbA1c from 10.2 % to 8.5 % (SD = 2.2, <em>p</em> = 0.04). In contrast, the control group showed a decrease in HbA1c from 9.95 % to 9.05 % (SD = 1.95, <em>p</em> = 0.05). Additionally, fasting blood glucose (FBG) levels in the intervention group decreased by 29 mg/dL, while the decline in the control group was not statistically significant, at 9 mg/dL. The difference in HbA1c levels was statistically significant, as determined by both <em>t</em>-tests.</div></div><div><h3>Conclusions</h3><div>As a member of a multidisciplinary team, a clinical pharmacist can play a crucial role in monitoring diabetes in hospitalized patients with heart conditions. Their interventions can more effectively lower HbA1c levels and fasting blood glucose (FBG) in these patients compared to standard care.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100248"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092415","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 : 2025-01-01DOI: 10.1016/j.deman.2024.100251
Sari Luthfiyah , Wannarat Lawang , Fathimath Shifaza
{"title":"Ramadan fasting among adults with type 2 diabetes in five geographically different regions of the world: The DAR 2020 global survey","authors":"Sari Luthfiyah , Wannarat Lawang , Fathimath Shifaza","doi":"10.1016/j.deman.2024.100251","DOIUrl":"10.1016/j.deman.2024.100251","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100251"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092264","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}
Type 2 diabetes mellitus (T2DM) is a pressing public health concern, contributing to 11 % of annual deaths and incurring direct expenses of $760 billion. Studies show intermittent fasting (IF) can effectively lower glycated haemoglobin (HbA1c) levels and reduce weight and levels in individuals with type 2 diabetes. The study's objective is to evaluate the efficacy and safety of IF on glycaemic control among patients with T2DM.
Methods
We conducted searches in the MEDLINE (Ovid), Embase, and SINOMED databases until February 29, 2024, focusing on glycaemic control as the outcome of interest. Secondary outcomes included changes in weight, and BMI (PROSPERO ID: CRD42022357598). We used a random effect model to synthesize the effect measure. We performed a sensitivity analysis to assess the robustness of the result.
Results
Out of the 24 studies identified, nine were deemed suitable for inclusion. Four studies, including 238 participants, were selected for the meta-analysis. The analysis revealed that IF and regular diets showed similar effects on glycemic control, HbA1c (−1.27 %, 95 % confidence interval [CI] −3.71 to 1.17) and fasting plasma glucose (−1.66, 95 % CI −4.22 to 0.90). Weight reduction outcomes were also similar between the two diets (−0.26, 95 % CI −1.43 to 0.91 kg). The frequency of hypoglycemic episodes was comparable across both groups.
Interpretation & conclusions
On the basis of moderate to low certainty of evidence, IF can be a safe dietary approach for patients with T2DM, with similar safety and effectiveness profiles to regular diets. However, larger-scale studies are recommended to confirm these findings.
{"title":"Efficacy and safety of intermittent fasting for type 2 diabetes mellitus: A systematic review and meta-analysis of randomized trials","authors":"Joshua Chadwick, Lavanya Ayyasamy, Madhanraj Kalyanasundaram, Ganeshkumar Parasuraman, Bhavani Shankara Bagepally, Jeyashree Kathiresan, Lokesh Shanmugam","doi":"10.1016/j.deman.2024.100249","DOIUrl":"10.1016/j.deman.2024.100249","url":null,"abstract":"<div><h3>Background & objectives</h3><div>Type 2 diabetes mellitus (T2DM) is a pressing public health concern, contributing to 11 % of annual deaths and incurring direct expenses of $760 billion. Studies show intermittent fasting (IF) can effectively lower glycated haemoglobin (HbA1c) levels and reduce weight and levels in individuals with type 2 diabetes. The study's objective is to evaluate the efficacy and safety of IF on glycaemic control among patients with T2DM.</div></div><div><h3>Methods</h3><div>We conducted searches in the MEDLINE (Ovid), Embase, and SINOMED databases until February 29, 2024, focusing on glycaemic control as the outcome of interest. Secondary outcomes included changes in weight, and BMI (PROSPERO ID: CRD42022357598). We used a random effect model to synthesize the effect measure. We performed a sensitivity analysis to assess the robustness of the result.</div></div><div><h3>Results</h3><div>Out of the 24 studies identified, nine were deemed suitable for inclusion. Four studies, including 238 participants, were selected for the meta-analysis. The analysis revealed that IF and regular diets showed similar effects on glycemic control, HbA1c (−1.27 %, 95 % confidence interval [CI] −3.71 to 1.17) and fasting plasma glucose (−1.66, 95 % CI −4.22 to 0.90). Weight reduction outcomes were also similar between the two diets (−0.26, 95 % CI −1.43 to 0.91 kg). The frequency of hypoglycemic episodes was comparable across both groups.</div></div><div><h3>Interpretation & conclusions</h3><div>On the basis of moderate to low certainty of evidence, IF can be a safe dietary approach for patients with T2DM, with similar safety and effectiveness profiles to regular diets. However, larger-scale studies are recommended to confirm these findings.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100249"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092420","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}
Type 2 diabetes is among the most prevalent endocrine disruptors. One of the most significant symptoms reported by diabetic patients is dry mouth, which results in reduced saliva buffering capacity and an increased risk of dental caries. So, the purpose of this study was to compare the oral health indicators of type 2 diabetic patients with non-diabetic controls.
Methods
In this case-control study, A total of 306 individuals included in the study (103 T2DM cases and 203 non-diabetic controls) in the age range of 40 to 60 years old. Participants were interviewed using a structured questionnaire including socio-demographics and oral health related to dry mouth factors. The clinical examination included full-mouth probing depths and an assessment of oral mucosal conditions to determine the DMFT index and identify any mucosal lesions. Data analysis was performed using SPSS software with a significance level set at 5 %.
Results
The patients had more probing depths >4 mm, tooth mobility, furcation involvement and missing teeth. The mean score of dry mouth and DMFT indexes were 3.38±2.64, 2.17±1.09 and 19.33±9.54, 15.48±6.93 in the case and control groups respectively. Also, the adjusted odds ratios (AOR) and their 95 % confidence Intervals (CI) reported a significant association as 2.96 (1.36–6.45), 5.90 (2.26–15.39), 0.23 (0.08–0.63) and 4.07 (1.74–9.49) for the above variables respectively.
Conclusion
Overall, the results of this study highlight that chronic periodontitis, tooth mobility, furcation and involvement were more prevalent among T2DM patients compared to non-diabetic controls. By recognizing these relationships and implementing targeted interventions, healthcare providers can improve oral health outcomes.
{"title":"Evaluation of oral health status in patients with type 2 diabetes","authors":"Tahmineh Khoshbakhti , Vajehallah Raeesi , Gholamreza Sharifzadeh , Leili Alizadeh","doi":"10.1016/j.deman.2024.100250","DOIUrl":"10.1016/j.deman.2024.100250","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes is among the most prevalent endocrine disruptors. One of the most significant symptoms reported by diabetic patients is dry mouth, which results in reduced saliva buffering capacity and an increased risk of dental caries. So, the purpose of this study was to compare the oral health indicators of type 2 diabetic patients with non-diabetic controls.</div></div><div><h3>Methods</h3><div>In this case-control study, A total of 306 individuals included in the study (103 T2DM cases and 203 non-diabetic controls) in the age range of 40 to 60 years old. Participants were interviewed using a structured questionnaire including socio-demographics and oral health related to dry mouth factors. The clinical examination included full-mouth probing depths and an assessment of oral mucosal conditions to determine the DMFT index and identify any mucosal lesions. Data analysis was performed using SPSS software with a significance level set at 5 %.</div></div><div><h3>Results</h3><div>The patients had more probing depths >4 mm, tooth mobility, furcation involvement and missing teeth. The mean score of dry mouth and DMFT indexes were 3.38±2.64, 2.17±1.09 and 19.33±9.54, 15.48±6.93 in the case and control groups respectively. Also, the adjusted odds ratios (AOR) and their 95 % confidence Intervals (CI) reported a significant association as 2.96 (1.36–6.45), 5.90 (2.26–15.39), 0.23 (0.08–0.63) and 4.07 (1.74–9.49) for the above variables respectively.</div></div><div><h3>Conclusion</h3><div>Overall, the results of this study highlight that chronic periodontitis, tooth mobility, furcation and involvement were more prevalent among T2DM patients compared to non-diabetic controls. By recognizing these relationships and implementing targeted interventions, healthcare providers can improve oral health outcomes.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100250"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092412","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 : 2024-11-13DOI: 10.1016/j.deman.2024.100247
Malek Zarei , Mohammad Abbas Sheikholeslami , Masoud Mozaffari , Yassar Mortada
Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease characterized by the selective destruction of pancreatic insulin-producing beta cells, primarily mediated by CD4+ and CD8+ T cells. This review comprehensively examines the latest advances in immunotherapeutic approaches to T1D, categorizing current strategies into four main groups: antigen-independent therapies, antigen-dependent therapies, beta cell therapies, and stem cell therapies. Antigen-independent strategies, such as antibody-based therapies (e.g., Abatacept and Teplizumab) and cytokine inhibitors (e.g., Anakinra and Etanercept), have shown potential in preserving beta cell function by modulating immune responses. Antigen-dependent strategies focus on inducing immune tolerance to specific beta cell antigens, with mixed results from clinical trials involving autoantigen vaccines like GAD65. Beta cell therapies, including islet transplantation, offer promising outcomes but face challenges related to immunosuppression and donor availability. Stem cell therapies, particularly using mesenchymal stem cells (MSCs) and autologous hematopoietic stem cells (HSCs), demonstrate potential in immune modulation and beta cell regeneration. Novel approaches, such as Chimeric Antigen Receptor (CAR)–Tregs therapy and JAK-STAT pathway inhibition, represent exciting areas of ongoing research. This comprehensive overview underscores the necessity of personalized therapeutic approaches and continued research to optimize existing therapies and explore new targets, ultimately aiming to improve outcomes and achieve a potential cure for T1D.
{"title":"Innovative immunotherapies and emerging treatments in type 1 diabetes management","authors":"Malek Zarei , Mohammad Abbas Sheikholeslami , Masoud Mozaffari , Yassar Mortada","doi":"10.1016/j.deman.2024.100247","DOIUrl":"10.1016/j.deman.2024.100247","url":null,"abstract":"<div><div>Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease characterized by the selective destruction of pancreatic insulin-producing beta cells, primarily mediated by CD4+ and CD8+ T cells. This review comprehensively examines the latest advances in immunotherapeutic approaches to T1D, categorizing current strategies into four main groups: antigen-independent therapies, antigen-dependent therapies, beta cell therapies, and stem cell therapies. Antigen-independent strategies, such as antibody-based therapies (e.g., Abatacept and Teplizumab) and cytokine inhibitors (e.g., Anakinra and Etanercept), have shown potential in preserving beta cell function by modulating immune responses. Antigen-dependent strategies focus on inducing immune tolerance to specific beta cell antigens, with mixed results from clinical trials involving autoantigen vaccines like GAD65. Beta cell therapies, including islet transplantation, offer promising outcomes but face challenges related to immunosuppression and donor availability. Stem cell therapies, particularly using mesenchymal stem cells (MSCs) and autologous hematopoietic stem cells (HSCs), demonstrate potential in immune modulation and beta cell regeneration. Novel approaches, such as Chimeric Antigen Receptor (CAR)–Tregs therapy and JAK-STAT pathway inhibition, represent exciting areas of ongoing research. This comprehensive overview underscores the necessity of personalized therapeutic approaches and continued research to optimize existing therapies and explore new targets, ultimately aiming to improve outcomes and achieve a potential cure for T1D.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100247"},"PeriodicalIF":1.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705641","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 : 2024-10-29DOI: 10.1016/j.deman.2024.100246
Raja Hazime , Saad Lamjadli , Morad Guennouni , Mounir Belkrachni , Fatima-Ezzohra Eddehbi , Ider Oujamaa , Lahcen Elmoumou , Aicha Bourrahouate , Imane Ait Sab , Hicham Baizri , Nawal El Ansari , Brahim Admou
Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in children and is associated with acute and serious chronic complications. T1D is characterized by the destruction of insulin-producing beta cells in the pancreas, with the emergence of circulating autoantibodies (a-Abs) targeting β cell antigens. Identifying autoantibodies can help predict the onset of T1D and associated autoimmune disorders, enhancing patient management strategies.
We aimed to determine the prevalence of T1D autoantibodies and their clinical significance in the pediatric and adult populations. A multicenter cross-sectional study was carried out on 276 patient-first with T1D, including 167 pediatric (60.5 %) and 109 adult (39.5 %) cases, of which 144 were female and 132 were male (sex ratio= 0.91),with an average age of 14.1 ± 8.0 years. The immunological investigation was based on the detection of T1D related a-Abs, including anti-insulin, anti-glutamic acid decarboxylase (GAD65), anti-insulinoma-associated antigen 2 (IA2), and anti-zinc transporter 8 (ZnT8) specificities. The results revealed an overall autoantibody seropositivity rate of 75.36 % (n= 208). Among the positive cases, GAD65 antibodies were the most prevalent at 37.31 %, followed by anti-insulin and anti-ZnT8 antibodies, each at 36.59 %, and anti-IA2 at 28.62 %. Additionally, 45,67 % of patients had one a-Abs, 28.36 % had a two, 21.15 % had three, and 4.8 % had all four a-Abs.
A statistically significant difference was observed between the seropositive and seronegative groups regarding the presence of associated autoimmune diseases (p = 0.005). These findings align with the existing literature, highlighting the importance and scientific value of detecting a-Abs in patients with T1D.
{"title":"Autoantibodies in type 1 diabetes: Prevalence and clinical profiles","authors":"Raja Hazime , Saad Lamjadli , Morad Guennouni , Mounir Belkrachni , Fatima-Ezzohra Eddehbi , Ider Oujamaa , Lahcen Elmoumou , Aicha Bourrahouate , Imane Ait Sab , Hicham Baizri , Nawal El Ansari , Brahim Admou","doi":"10.1016/j.deman.2024.100246","DOIUrl":"10.1016/j.deman.2024.100246","url":null,"abstract":"<div><div>Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in children and is associated with acute and serious chronic complications. T1D is characterized by the destruction of insulin-producing beta cells in the pancreas, with the emergence of circulating autoantibodies (a-Abs) targeting β cell antigens. Identifying autoantibodies can help predict the onset of T1D and associated autoimmune disorders, enhancing patient management strategies.</div><div>We aimed to determine the prevalence of T1D autoantibodies and their clinical significance in the pediatric and adult populations. A multicenter cross-sectional study was carried out on 276 patient-first with T1D, including 167 pediatric (60.5 %) and 109 adult (39.5 %) cases, of which 144 were female and 132 were male (sex ratio= 0.91),with an average age of 14.1 ± 8.0 years. The immunological investigation was based on the detection of T1D related a-Abs, including anti-insulin, anti-glutamic acid decarboxylase (GAD65), anti-insulinoma-associated antigen 2 (IA2), and anti-zinc transporter 8 (ZnT8) specificities. The results revealed an overall autoantibody seropositivity rate of 75.36 % (n= 208). Among the positive cases, GAD65 antibodies were the most prevalent at 37.31 %, followed by anti-insulin and anti-ZnT8 antibodies, each at 36.59 %, and anti-IA2 at 28.62 %. Additionally, 45,67 % of patients had one a-Abs, 28.36 % had a two, 21.15 % had three, and 4.8 % had all four a-Abs.</div><div>A statistically significant difference was observed between the seropositive and seronegative groups regarding the presence of associated autoimmune diseases (p = 0.005). These findings align with the existing literature, highlighting the importance and scientific value of detecting a-Abs in patients with T1D.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100246"},"PeriodicalIF":1.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657375","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 : 2024-10-15DOI: 10.1016/j.deman.2024.100240
Camilla Mattiuzzi, Giuseppe Lippi
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Pub Date : 2024-10-09DOI: 10.1016/j.deman.2024.100239
Tran Bao Vuong , Triet Minh Tran , Nam Quang Tran
Objectives
The prevalences of diabetes and prediabetes have increased rapidly in recent years in emerging nations such as Vietnam, particularly in the population at high risk of diabetes. This study aimed to investigate the prevalence of prediabetes and undiagnosed diabetes in individuals at high risk of type 2 diabetes (T2D), as well as the related risk factors.
Methods
This cross-sectional study at the clinics of the University Medical Center in Ho Chi Minh City included 360 patients who were 18 years of age or older, and were at risk of developing T2D. The diagnosis of prediabetes and diabetes relied on measurements of fasting plasma glucose, HbA1c, and 2-hour plasma glucose after a 75 g oral glucose tolerance test.
Results
The prevalence of prediabetes was 60.6 % (95 % CI: 55.3–65.6 %), and the prevalence of diabetes was 18.3 % (95 % CI: 14.6–22.8 %). Older age (OR = 1.06), obesity (OR = 3.89), hypertension (OR = 5.71), and dyslipidemia (OR = 2.01) were factors associated with increasing frequencies of undiagnosed T2D and prediabetes.
Conclusion
The prevalences of prediabetes and undiagnosed diabetes were significantly higher among people with a high-risk of dysglycemia in Vietnam. There is a need for screening programs for such high-risk individuals.
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