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Outcomes for Patients with Diabetic Foot Ulcers Following Transition from Medicaid to Commercial Insurance. 从医疗补助过渡到商业保险后糖尿病足溃疡患者的治疗效果。
IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-01 Epub Date: 2024-08-21 DOI: 10.3390/diabetology5030027
KiBeom Kwon, Taylor A Brown, Juan C Arias Aristizábal, David G Armstrong, Tze-Woei Tan

Objective: This study investigates the outcomes of Medicaid beneficiaries with diabetic foot ulcers (DFUs) who had transitioned to commercial insurance.

Methods: We utilized the PearlDiver claims database to identify adult patients diagnosed with a new DFU between 2010 and 2019. The study cohort comprised 8856 Medicaid beneficiaries who had at least three years of continuous enrollment after DFU diagnosis. Medicaid beneficiaries who transitioned to Medicare during follow-up were excluded. Adjusted comparisons of outcomes were performed by propensity matching the two groups for age, gender, and Charlson Comorbidity Index (CCI) in a 1:1 ratio. We used logistic regression and Kaplan-Meier estimate to evaluate the association between insurance change (from Medicaid to commercial insurance) and major amputation.

Results: Among the 8856 Medicaid beneficiaries with DFUs, 66% (n = 5809) had transitioned to commercial insurance coverage during follow-up. The overall major amputation rate was 2.8% (n = 247), with a lower rate observed in patients who transitioned to commercial insurance compared to those with continuous Medicaid coverage (2.6% vs. 3.2%, p < 0.05). In multivariable analysis, Medicaid beneficiaries who transitioned to commercial insurance had a 27% lower risk of major amputation (study cohort: odds ratios [OR] 0.75, 95% CI 0.56-0.97, p = 0.03; matched cohort: OR 0.65, 95% 0.22, 0.55, p = 0.01) compared to those with continuous Medicaid coverage.

Conclusions: Transitioning from Medicaid to commercial insurance may be associated with a lower risk of major amputation among Medicaid beneficiaries with DFUs.

目的:本研究调查了患有糖尿病足溃疡(DFU)的医疗补助受益人在过渡到商业保险后的治疗效果:本研究调查了糖尿病足溃疡(DFU)医疗补助受益人转为商业保险后的治疗效果:我们利用 PearlDiver 索偿数据库来识别 2010 年至 2019 年期间诊断出新的 DFU 的成年患者。研究队列包括 8856 名医疗补助受益人,他们在确诊 DFU 后至少连续参保三年。不包括在随访期间转入医疗保险的医疗补助受益人。通过按 1:1 的比例对两组患者的年龄、性别和 Charlson 生病指数 (CCI) 进行倾向匹配,对结果进行调整比较。我们使用逻辑回归和 Kaplan-Meier 估计来评估保险变更(从医疗补助转为商业保险)与大截肢之间的关系:在 8856 名患有 DFU 的医疗补助受益人中,66%(n = 5809)在随访期间转为商业保险。总体大截肢率为 2.8%(n = 247),与持续享受医疗补助的患者相比,转为商业保险的患者大截肢率较低(2.6% vs. 3.2%,p < 0.05)。在多变量分析中,过渡到商业保险的医疗补助受益人发生大截肢的风险比持续享受医疗补助的受益人低 27%(研究队列:几率比 [OR] 0.75,95% CI 0.56-0.97,p = 0.03;匹配队列:OR 0.65,95% 0.22,0.55,p = 0.01):结论:在患有 DFU 的医疗补助受益人中,从医疗补助过渡到商业保险可能与较低的大截肢风险有关。
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引用次数: 0
Diet Supplementation with Rosemary (Rosmarinus officinalis L.) Leaf Powder Exhibits an Antidiabetic Property in Streptozotocin-Induced Diabetic Male Wistar Rats 饮食中添加迷迭香(Rosmarinus officinalis L.)叶粉对链脲佐菌素诱导的糖尿病雄性 Wistar 大鼠具有抗糖尿病作用
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-04 DOI: 10.3390/diabetology5010002
Zelipha N. Kabubii, J. Mbaria, P. M. Mathiu, John M. Wanjohi, Evans N. Nyaboga
Diabetes mellitus is a metabolic disorder that has a high global health burden and causes high mortality and morbidity in humans. Medicinal herbs and plants offer a promising alternative to conventional therapies for the management of diabetes. Rosemary (Rosmarinus officinalis L.) is a traditional medicinal herb that has been used for the management of several diseases. Therefore, the present study investigates the antidiabetic properties of diets supplemented with R. officinalis leaf powder on streptozotocin-induced diabetic Wistar rats. First, the phytochemicals and 2,2-dephenyl-1-picrylhydrazyl (DPPH) free-radical scavenging activity of aqueous R. officinalis leaf extract were determined. Streptozotocin-induced diabetic male Wistar rats were fed a diet supplemented with R. officinalis leaf powder (ROP) at 3%, 6%, and 12%, respectively, for 6 weeks. Investigations of food intake, body weight, rat relative organ weights, blood glucose, lipid profiles, creatinine, bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were estimated according to standard procedures. The results show that ROP aqueous extract contains significant amounts of phenolics, flavonoids, and tannins, which exhibit in vitro DPPH free-radical scavenging activity. Based on an in vivo study, ROP reduced blood glucose levels in streptozotocin-induced diabetic animals (p < 0.05). Dietary supplementation with ROP in diabetic rats significantly (p < 0.05) lowered ALT, AST, bilirubin, creatinine, total triglyceride (TG), total cholesterol (TC), and low-density lipoprotein (LDL) levels while increasing high-density lipoproteins (HDLs) when compared with the diabetic control group. Our findings demonstrate that a diet supplemented with R. officinalis leaf powder exhibits an antidiabetic potential with improved health outcomes, as demonstrated by the improved lipid and liver profile enzymes in our animal model.
糖尿病是一种代谢紊乱疾病,对全球健康造成沉重负担,并导致高死亡率和高发病率。药用草本植物为治疗糖尿病提供了一种替代传统疗法的可行方法。迷迭香(Rosmarinus officinalis L.)是一种传统药草,一直被用于治疗多种疾病。因此,本研究调查了补充迷迭香叶粉的膳食对链脲佐菌素诱导的糖尿病 Wistar 大鼠的抗糖尿病特性。首先,测定了 R. officinalis 水提取物的植物化学成分和 2,2-二苯基-1-苦基肼(DPPH)自由基清除活性。以链脲菌素诱导的雄性 Wistar 大鼠为研究对象,在其饮食中分别添加 3%、6% 和 12% 的 R. officinalis 叶粉(ROP),连续喂养 6 周。按照标准程序对大鼠的进食量、体重、相对器官重量、血糖、血脂、肌酐、胆红素、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)进行了测定。结果表明,ROP 水提取物含有大量酚类、黄酮类和单宁酸,具有体外 DPPH 自由基清除活性。根据体内研究,ROP 可降低链脲佐菌素诱导的糖尿病动物的血糖水平(p < 0.05)。与糖尿病对照组相比,糖尿病大鼠膳食中补充 ROP 能显著降低 ALT、AST、胆红素、肌酐、总甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白(LDL)水平(p < 0.05),同时增加高密度脂蛋白(HDLs)。我们的研究结果表明,补充茜草叶粉的膳食具有抗糖尿病的潜力,并能改善健康状况,动物模型中血脂和肝脏酶谱的改善就证明了这一点。
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引用次数: 0
Does the Efficacy of Semaglutide Treatment Differ between Low-Risk and High-Risk Subgroups of Patients with Type 2 Diabetes and Obesity Based on SCORE2, SCORE2-Diabetes, and ASCVD Calculations? 根据 SCORE2、SCORE2-糖尿病和 ASCVD 计算结果,2 型糖尿病和肥胖症患者的低风险亚组和高风险亚组之间的塞马鲁肽疗效是否存在差异?
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-04 DOI: 10.3390/diabetology5010003
Martina Matovinović, Andrej Belančić, Juraj Jug, F. Mustač, Maja Sirovica, Mihovil Santini, Anja Bošnjaković, M. Lovrić, M. Lovrić Benčić
Background: Diabetes is the primary contributor to cardiovascular disease risk, and when combined with obesity, it further underscores the significance of cardiovascular risk assessment. Methods: A retrospective study of 64 patients with type 2 diabetes (T2D) and obesity on once-weekly subcutaneous semaglutide stratified by cardiovascular risk categories determined using the SCORE2/SCORE2-OP, SCORE2-Diabetes, and ASCVD score calculations. We compare the differences between groups (ASCVD: low + borderline + intermediate versus high-risk group; SCORE2/SCORE2-OP: low + moderate versus high + very high-risk group and SCORE2-Diabetes: low + moderate versus high + very high-risk group) in terms of change from baseline in body mass index (BMI) and HbA1c and weight loss outcomes. Results: Patients in the high-risk group, according to ASCVD risk score, had statistically better results in weight loss ≥ 3%, ≥5%, and ≥10% compared to ASCVD low + borderline + intermediate and without difference regarding HbA1c. According to SCORE2/SCORE2-OP, the high + very high-risk group had statistically better HbA1c and weight loss results but only for ≥5% versus the low + moderate risk group. Based on the score SCORE2-Diabetes, the high + very high-risk group had statistically significant better results in lowering HbA1c and weight loss but only for ≥5% versus the low + moderate risk group. Conclusions: To the best of our knowledge, this study represents the initial investigation linking glycemic control and weight reduction outcomes in individuals with T2D and obesity treated with once-weekly semaglutide stratified by cardiovascular risk categories determined using the SCORE2/SCORE2-OP, SCORE2-Diabetes and ASCVD score calculations.
背景:糖尿病是导致心血管疾病风险的主要因素,如果合并肥胖症,则进一步凸显了心血管风险评估的重要性。研究方法对64名2型糖尿病(T2D)和肥胖症患者进行回顾性研究,这些患者每周服用一次皮下注射的塞马鲁肽,根据SCORE2/SCORE2-OP、SCORE2-糖尿病和ASCVD评分计算得出的心血管风险类别进行分层。我们比较了各组(ASCVD:低风险组 + 边缘 + 中度风险组与高风险组;SCORE2/SCORE2-OP:低风险组 + 中度风险组与高风险组 + 极高风险组;SCORE2-糖尿病:低风险组 + 中度风险组与高风险组 + 极高风险组)在体重指数 (BMI) 和 HbA1c 以及体重减轻结果与基线相比的变化差异。结果根据 ASCVD 风险评分,与 ASCVD 低度 + 边缘 + 中度组相比,高风险组患者在体重减轻≥3%、≥5% 和≥10% 方面有更好的统计结果,而在 HbA1c 方面没有差异。根据 SCORE2/SCORE2-OP,高风险组和极高风险组的 HbA1c 和体重减轻结果在统计学上更好,但与低风险组和中等风险组相比,仅在≥5% 时有更好的结果。根据 SCORE2-Diabetes 评分,高风险+极高风险组在降低 HbA1c 和减轻体重方面的结果在统计学上明显优于低风险+中度风险组,但仅在降低 HbA1c 和减轻体重≥5%方面优于低风险+中度风险组。结论:据我们所知,本研究是首次对使用每周一次的塞马鲁肽治疗的 T2D 和肥胖症患者的血糖控制和体重减轻效果进行研究,这些患者的血糖控制和体重减轻效果是根据 SCORE2/SCORE2-OP、SCORE2-糖尿病和 ASCVD 评分计算得出的心血管风险类别进行分层的。
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引用次数: 0
A Comparative Analysis of Machine Learning Models for the Detection of Undiagnosed Diabetes Patients 用于检测未确诊糖尿病患者的机器学习模型比较分析
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-03 DOI: 10.3390/diabetology5010001
S. Cichosz, Clara Bender, Ole Hejlesen
Introduction: Early detection of type 2 diabetes is essential for preventing long-term complications. However, screening the entire population for diabetes is not cost-effective, so identifying individuals at high risk for this disease is crucial. The aim of this study was to compare the performance of five diverse machine learning (ML) models in classifying undiagnosed diabetes using large heterogeneous datasets. Methods: We used machine learning data from several years of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 to identify people with undiagnosed diabetes. The dataset included 45,431 participants, and biochemical confirmation of glucose control (HbA1c) were used to identify undiagnosed diabetes. The predictors were based on simple and clinically obtainable variables, which could be feasible for prescreening for diabetes. We included five ML models for comparison: random forest, AdaBoost, RUSBoost, LogitBoost, and a neural network. Results: The prevalence of undiagnosed diabetes was 4%. For the classification of undiagnosed diabetes, the area under the ROC curve (AUC) values were between 0.776 and 0.806. The positive predictive values (PPVs) were between 0.083 and 0.091, the negative predictive values (NPVs) were between 0.984 and 0.99, and the sensitivities were between 0.742 and 0.871. Conclusion: We have demonstrated that several types of classification models can accurately classify undiagnosed diabetes from simple and clinically obtainable variables. These results suggest that the use of machine learning for prescreening for undiagnosed diabetes could be a useful tool in clinical practice.
简介早期发现 2 型糖尿病对预防长期并发症至关重要。然而,对所有人群进行糖尿病筛查并不划算,因此识别高危人群至关重要。本研究旨在比较五种不同的机器学习(ML)模型在使用大型异构数据集对未确诊糖尿病进行分类时的性能。研究方法我们使用从 2005 年到 2018 年连续几年的美国国家健康与营养调查(NHANES)的机器学习数据来识别未确诊的糖尿病患者。数据集包括 45,431 名参与者,使用葡萄糖控制的生化确认(HbA1c)来识别未确诊的糖尿病患者。预测因子基于简单且临床上可获得的变量,可用于糖尿病的预筛查。我们将随机森林、AdaBoost、RUSBoost、LogitBoost 和神经网络等五种 ML 模型进行了比较。结果未确诊糖尿病的发病率为 4%。在对未确诊糖尿病进行分类时,ROC 曲线下面积(AUC)值介于 0.776 和 0.806 之间。阳性预测值(PPV)介于 0.083 和 0.091 之间,阴性预测值(NPV)介于 0.984 和 0.99 之间,灵敏度介于 0.742 和 0.871 之间。结论我们已经证明,几种类型的分类模型可以从简单的、临床上可获得的变量中准确地对未确诊的糖尿病进行分类。这些结果表明,在临床实践中,使用机器学习预检未确诊糖尿病可能是一种有用的工具。
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引用次数: 0
Comorbidity of Type 2 Diabetes and Dementia among Hospitalized Patients in Los Angeles County: Hospitalization Outcomes and Costs, 2019–2021 洛杉矶县住院患者中 2 型糖尿病和痴呆症的合并症:2019-2021年住院结果和成本
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-12-18 DOI: 10.3390/diabetology4040052
D’Artagnan M. Robinson, Dalia Regos-Stewart, Mariana A. Reyes, Tony Kuo, N. Barragan
Hospitalizations for diabetes and dementia can impose a significant health and economic toll on older adults in the United States. This study sought to examine differences in hospitalization characteristics and outcomes associated with diabetes and dementia, separately and together, using 2019–2021 discharge record data from the California Department of Health Care Access and Information. The sampled group were residents of Los Angeles County who were aged 50+ at the time of the study. The multivariable linear regression analysis showed that compared to those with no diabetes or dementia, patients with diabetes alone exhibited the highest total charges, while those with comorbid diabetes and dementia exhibited lower charges (p < 0.05). The multinomial logistic regression found that patients with comorbid diabetes and dementia had the highest odds of having a length of stay of 7+ days (Adjusted Odds Ratio = 1.49; 95% Confidence Interval (CI) = 1.44–1.53). A matched case–control analysis revealed that comorbid diabetes and dementia were associated with significantly lower odds of hypertensive disease than diabetes alone (Matched Odds Ratio = 0.81; 95% CI = 0.67–0.97). Collectively, these results highlight the complex factors that may influence the variable hospitalization outcomes that are common occurrences in these three distinct disease profiles. Study findings suggest a need to consider these complexities when developing policies or strategies to improve hospitalization outcomes for these conditions.
在美国,糖尿病和痴呆症的住院治疗会给老年人带来巨大的健康和经济损失。本研究试图利用加利福尼亚州医疗保健访问和信息部提供的 2019-2021 年出院记录数据,分别和共同研究与糖尿病和痴呆症相关的住院特征和结果的差异。抽样群体是洛杉矶县的居民,研究时年龄在 50 岁以上。多变量线性回归分析显示,与没有糖尿病或痴呆症的患者相比,单纯糖尿病患者的总费用最高,而合并糖尿病和痴呆症的患者费用较低(P < 0.05)。多项式逻辑回归发现,合并糖尿病和痴呆症的患者住院时间超过 7 天的几率最高(调整后比值比 = 1.49;95% 置信区间 (CI) = 1.44-1.53)。一项匹配病例对照分析显示,合并糖尿病和痴呆症的患者患高血压疾病的几率明显低于合并糖尿病的患者(匹配几率比 = 0.81;95% 置信区间 = 0.67-0.97)。总之,这些结果凸显了可能影响不同住院结果的复杂因素,而这些因素在这三种不同的疾病特征中是经常出现的。研究结果表明,在制定政策或策略以改善这些疾病的住院治疗结果时,需要考虑这些复杂因素。
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引用次数: 0
Global Trends in Risk Factors and Therapeutic Interventions for People with Diabetes and Cardiovascular Disease: Results from the WHO International Clinical Trials Registry Platform 糖尿病和心血管疾病患者风险因素和治疗干预的全球趋势:世界卫生组织国际临床试验登记平台的结果
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-12-08 DOI: 10.3390/diabetology4040050
Musawenkosi Ndlovu, P. Dludla, N. Muvhulawa, Yonela Ntamo, Asanda Mayeye, Nomahlubi Luphondo, Nokulunga Hlengwa, A. Basson, S. Mabhida, S. Hanser, S. Mazibuko-Mbeje, B. Nkambule, D. Ndwandwe
This study presents a comprehensive analysis of 898 clinical trials conducted between 1999 and 2023, focusing on the interplay of metabolic syndrome, cardiovascular diseases (CVDs), and type 2 diabetes mellitus (T2D). This study draws upon data sourced from the International Clinical Trials Registry Platform (ICTRP) until August 2023. The trials were predominantly interventional (67%) or observational (33%). A geographical distribution reveals that while the United States registered approximately 18% of the trials, other regions like Australia, the United Kingdom, and multicounty trials made substantial contributions. Most studies (84%) included both male and female participants, with adults aged 18 to 65 years predominantly represented. The trials aimed at treatment (21%) and prevention (21%), emphasizing the dual focus on addressing existing CVD risk and preventing its development. Notably, CVDs (29%), T2D (8%), and the coexistence of both (21%) constituted the primary conditions of interest. Key interventions encompassed lifestyle and behavioral modifications, dietary supplementation, and drug therapies, with metformin and statins leading in pharmacological treatments. Interestingly, additional interventions such as glucagon-like peptide-1 agonists and dipeptidyl peptidase IV inhibitors are gaining recognition for their potential in managing metabolic syndrome-related conditions. Moreover, the report highlights a growing focus on inflammation, body mass index, blood pressure, body weight, and major adverse cardiovascular events as primary outcomes. Overall, the study highlights the importance of ICTRP as the source of data for clinical trials targeting metabolic syndrome, CVDs, and T2D and the growing recognition of diverse intervention strategies to address this critical global health concern.
本研究对1999年至2023年间进行的898项临床试验进行了综合分析,重点关注代谢综合征、心血管疾病(cvd)和2型糖尿病(T2D)之间的相互作用。本研究的数据来源于国际临床试验注册平台(ICTRP),截止到2023年8月。这些试验主要是干预性(67%)或观察性(33%)。地理分布表明,虽然美国登记了大约18%的试验,但澳大利亚、英国和多国试验等其他地区贡献很大。大多数研究(84%)包括男性和女性参与者,以18至65岁的成年人为主。试验的目标是治疗(21%)和预防(21%),强调双重关注解决现有的心血管疾病风险和预防其发展。值得注意的是,cvd(29%)、T2D(8%)以及两者共存(21%)构成了研究的主要条件。主要的干预措施包括生活方式和行为改变、饮食补充和药物治疗,以二甲双胍和他汀类药物为主导的药物治疗。有趣的是,其他干预措施,如胰高血糖素样肽-1激动剂和二肽基肽酶IV抑制剂,因其在治疗代谢综合征相关疾病方面的潜力而得到认可。此外,该报告强调,炎症、体重指数、血压、体重和主要不良心血管事件作为主要结局越来越受到关注。总的来说,该研究强调了ICTRP作为针对代谢综合征、心血管疾病和T2D的临床试验数据来源的重要性,以及对解决这一关键全球健康问题的多种干预策略的日益认识。
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引用次数: 0
Could Microbiome Be the Common Co-Denominator between Type 2 Diabetes and Pancreatic Cancer? 微生物组可能是 2 型糖尿病和胰腺癌之间的共同致病因子吗?
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-12-07 DOI: 10.3390/diabetology4040049
M. Golčić, Andrej Belančić
Similar microorganisms, via similar mechanisms, play a role in the development of both pancreatic cancer (PC) and type 2 diabetes (T2D). Since the new onset of T2D is potentially one of the earliest signs of PC, it is highly plausible that a common denominator might be responsible for both, as the growth of the cancer will take a longer time to manifest compared to the insulin resistance. Although a variety of host-dependent factors and susceptibility play a role, and the mechanisms connecting the two diseases remain poorly understood, future well-designed trials should hypothesize whether a microbial intervention (modification and/or transplantation) results in a lower incidence and the better treatment of both diseases since the T2D–PC–gut microbiome interconnection seems scientifically logical.
相似的微生物,通过相似的机制,在胰腺癌(PC)和2型糖尿病(T2D)的发展中发挥作用。由于T2D的新发病可能是PC的早期征兆之一,因此两者的共同原因可能是非常可信的,因为与胰岛素抵抗相比,癌症的生长需要更长的时间才能表现出来。尽管多种宿主依赖因素和易感性发挥了作用,并且连接这两种疾病的机制仍然知之甚少,但未来设计良好的试验应该假设微生物干预(修饰和/或移植)是否会导致两种疾病的发病率降低和更好的治疗,因为t2d - pc -肠道微生物组的相互联系似乎在科学上合乎逻辑。
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引用次数: 0
Importance of Dyslipidaemia Treatment in Individuals with Type 2 Diabetes Mellitus—A Narrative Review 2 型糖尿病患者血脂异常治疗的重要性--叙述性综述
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-12-04 DOI: 10.3390/diabetology4040048
Dominik Strikić, Andro Vujević, D. Perica, D. Leskovar, Kristina Paponja, I. Pećin, I. Merćep
Type 2 diabetes mellitus (T2DM) is a common metabolic disease characterised by insulin resistance and elevated blood glucose levels, affecting millions of people worldwide. T2DM individuals with dyslipidaemia have an increased risk of cardiovascular disease (CVD). A complex interplay of risk factors such as hyperglycaemia, dyslipidaemia, hypertension, obesity, inflammation, and oxidative stress favour the development of atherosclerosis, a central mechanism in the pathogenesis of cardiovascular disease. Dyslipidaemia, a hallmark of T2DM, is characterised by elevated triglycerides, decreased high-density lipoprotein (HDL) cholesterol and the presence of small, dense low-density lipoprotein (LDL) particles, all of which promote atherosclerosis. In this article, we have attempted to present various treatment strategies that include pharmacological interventions such as statins, ezetimibe, PCSK9 inhibitors, fibrates, and omega-3 fatty acids. We have also tried to highlight the pivotal role of lifestyle modifications, including physical activity and dietary changes, in improving lipid profiles and overall cardiovascular health in T2DM individuals. We have also tried to present the latest clinical guidelines for the management of dyslipidaemia in T2DM individuals. In conclusion, the treatment of dyslipidaemia in T2DM individuals is of great importance as it lowers lipid particle levels, slows the progression of atherosclerosis, and ultimately reduces susceptibility to cardiovascular disease.
2型糖尿病(T2DM)是一种以胰岛素抵抗和血糖水平升高为特征的常见代谢性疾病,影响着全世界数百万人。伴有血脂异常的2型糖尿病患者发生心血管疾病(CVD)的风险增加。高血糖、血脂异常、高血压、肥胖、炎症和氧化应激等危险因素的复杂相互作用有利于动脉粥样硬化的发展,这是心血管疾病发病机制的核心机制。血脂异常是T2DM的一个标志,其特征是甘油三酯升高,高密度脂蛋白(HDL)胆固醇降低,存在小而致密的低密度脂蛋白(LDL)颗粒,所有这些都促进动脉粥样硬化。在这篇文章中,我们试图提出各种治疗策略,包括药物干预,如他汀类药物、依折替米贝、PCSK9抑制剂、贝特类药物和omega-3脂肪酸。我们还试图强调生活方式的改变,包括身体活动和饮食的改变,在改善2型糖尿病患者的血脂和整体心血管健康方面的关键作用。我们也试图提出最新的2型糖尿病患者血脂异常管理的临床指南。总之,治疗2型糖尿病患者的血脂异常非常重要,因为它可以降低脂质颗粒水平,减缓动脉粥样硬化的进展,最终降低心血管疾病的易感性。
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引用次数: 0
Correction: Brandão Palma et al. Biological Evidence of Improved Wound Healing Using Autologous Micrografts in a Diabetic Animal Model. Diabetology 2023, 4, 294–311 更正:Brandão Palma 等人,在糖尿病动物模型中使用自体微移植改善伤口愈合的生物学证据。糖尿病学》2023 年第 4 期,294-311 页
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-11-24 DOI: 10.3390/diabetology4040047
The Diabetology Editorial Office would like to make the following correction to the published paper [...]
糖尿病学》编辑部谨对已发表的论文作如下更正 [...]
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引用次数: 0
Sexual Dysfunction in Female Patients with Type 2 Diabetes Mellitus—Sneak Peek on an Important Quality of Life Determinant 女性2型糖尿病患者的性功能障碍——一个重要的生活质量决定因素
Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-11-13 DOI: 10.3390/diabetology4040046
Marija Rogoznica, Dražen Perica, Barbara Borovac, Andrej Belančić, Martina Matovinović
Type 2 diabetes mellitus (T2DM) is a multisystemic disease with a high global burden and chronic complications. Sexual dysfunction (SD) in patients with T2DM is an often-overlooked complication, despite its high impact on quality of life (QoL). Female sexual disorders can affect women of reproductive age as well as menopausal women. Proposed mechanisms are intertwining a variety of physiological, neurological, vascular, hormonal, and psychological variables. The impairment of sexual function has been linked to hyperglycemia, insulin resistance, chronic low-grade inflammation, endothelial dysfunction, neuropathy, and hormonal abnormalities. There are many different manifestations of female sexual dysfunction, such as insufficient sexual desire, diminished arousal, difficulty in eliciting orgasm, and pain during sexual engagement. Numerous studies have shown that the QoL of patients living with diabetes mellitus (DM) is lower than that of those without DM. SD in women with T2DM leads to deteriorated QoL. Treatment must be individualized based on the diagnosis and the sexual dysfunction as well as underlying medical, psychological, and interpersonal issues. The goal of modern medical care for patients living with diabetes is not to delay death but to improve their health and QoL. The present review article aimed to raise awareness about female sexual dysfunction in patients with T2DM and to provide an overview of its impact on QoL.
2型糖尿病(T2DM)是一种全球性高负担和慢性并发症的多系统疾病。2型糖尿病患者的性功能障碍(SD)是一个经常被忽视的并发症,尽管它对生活质量(QoL)有很大的影响。女性性功能障碍可影响育龄妇女和更年期妇女。提出的机制是各种生理、神经、血管、激素和心理变量交织在一起的。性功能障碍与高血糖、胰岛素抵抗、慢性低度炎症、内皮功能障碍、神经病变和激素异常有关。女性性功能障碍有许多不同的表现,如性欲不足、性欲减退、难以达到性高潮、性交时疼痛等。大量研究表明,糖尿病(DM)患者的生活质量低于非糖尿病患者。女性T2DM患者的SD导致生活质量恶化。治疗必须根据诊断和性功能障碍以及潜在的医学、心理和人际关系问题进行个性化治疗。现代医疗护理糖尿病患者的目标不是延迟死亡,而是改善他们的健康和生活质量。本文旨在提高对女性2型糖尿病患者性功能障碍的认识,并概述其对生活质量的影响。
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引用次数: 0
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Diabetology
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