BMC Endocrine Disorders最新文献

Background: The common recommendation for hypoglycemia treatment, oral ingestion of 15 g of simple carbohydrates and glucose recheck in 15 min, was predominantly based on expert opinion, and two small-sized studies of intravenous insulin-induced hypoglycemia in people living with type 1 diabetes mellitus (T1D). The evidence for "15 grams/15 minutes" treatment for people living with type 2 diabetes mellitus (T2D) needs to be explored. The objective of this systematic review is to determine which oral carbohydrate treatments were studied in adults living with T2D for timely resolution of hypoglycemia events.

Methods: Medline, Embase, Scopus, and Cochrane Central Register of Controlled Trials were searched from January 1990 to 24 March 2025, for full-text studies of oral treatment for hypoglycemia in T2D. Two authors screened the results and extracted data. Inclusion criteria included age > = 18 years with T2D, treated with a defined quantity of simple carbohydrates, and reported hypoglycemia event resolution as a defined time of first glucose recheck after treatment completion. Exclusion criteria included non-oral route of hypoglycemia treatment. The Newcastle-Ottawa scale was used for risk of bias assessment.

Results: Three studies were included, which reported on 152 insulin-treated adults who experienced 366 hypoglycemia events. None of these three studies presented if the participants were or were not on sulfonylurea concurrently, nor did they present a breakdown of the types of insulin(s) (long-acting versus rapid-acting) for the participants. All studies had different oral hypoglycemia treatments and various glucose recheck times. Hence, data synthesis was not possible. There was near 100% hypoglycemia resolution with 15 g carbohydrates at 30-minute recheck in a study of mild hypoglycemia in hospitalized people living with type 2 diabetes. An at-home study showed 95% hypoglycemia resolution with 30 g carbohydrates at 10-minute recheck, although rebound hyperglycemia became a concern. The studies had low risk of bias.

Conclusion: Three studies provided a very limited evidence base for hypoglycemia treatment in T2D. Future studies are encouraged to identify and analyze people living with T2D who are treated with sulfonylurea, with or without insulin therapy, to reflect hypoglycemia treatment over the breadth of T2D pharmacotherapy.

Clinical trial number: Not applicable.

Trial registration: Prospero registration number CRD420251032322. No amendments. Study protocol can be obtained by sending a written request to the corresponding author.

Background: This investigation employed a prospective observational design to examine pruritus, a common dermatological manifestation in type 2 diabetes mellitus (T2DM) patients that significantly impacts both physical health and psychological status. The primary aim was to elucidate potential risk factors contributing to pruritic symptoms in this patient population.

Methods: We consecutively enrolled T2DM patients presenting to our endocrinology department from April to December 2023. Comprehensive data collection included demographic characteristics, pruritus symptom profiles, and standard biochemical parameters through structured questionnaires. Non-invasive cutaneous assessments measured transepidermal water loss (TEWL) and stratum corneum hydration (SCH). Flow cytometric analysis quantified Th1/Th2 cell populations, while serum concentrations of IL-4 and IFN-γ were determined via ELISA.

Results: Among 110 participants (26 non-pruritic, 84 pruritic), multivariate analysis identified several significant associations (P < 0.05). Key correlates included fasting plasma glucose (FPG), diabetes duration, presence of diabetic peripheral neuropathy (DPN) or nephropathy, hyperuricemia, IL-4 and IFN-γ levels, and SCH in both upper and lower limbs. Logistic regression showed that FPG, diabetes duration, presence of hyperuricemia, IL-4, and SCH measurements inl ower limbs were the risk factor of pruritus combined T2DM. In chronic pruritus cases, severe symptoms correlated with elevated FPG, increased DPN prevalence, and reduced lower limb SCH compared to milder cases (P < 0.05). Acute pruritus severity showed similar FPG associations, with additional significant SCH reductions in both extremities compared to moderate cases (P < 0.05).

Conclusion: Our findings suggest that FPG, diabetes duration, presence of hyperuricemia, IL-4, and SCH measurements in lower limbs were the risk factor of pruritus combined T2DM. Chronic pruritus severity appears related to metabolic control, neurological involvement, immune inflammation and skin hydration, while acute cases primarily associate with metabolic, immune inflammation and skin hydration. The observed Th1/Th2 imbalance, with progressive ratio decline accompanying symptom worsening, potentially indicates type 2 inflammatory pathway activation in diabetic patients experiencing pruritus.

Background: Triglyceride-glucose (TyG) index has emerged as a reliable surrogate marker for insulin resistance and an early indicator of metabolic dysfunction. However, its association with inflammatory markers and adipokine dysregulation in patients with metabolic syndrome (MetS) remains poorly understood. This study aimed to investigate the association of the TyG index with inflammatory biomarkers and adipokine profiles in adults diagnosed with MetS.

Methods: This cross-sectional study included 190 adults (aged 20-50 years) with metabolic syndrome (MetS), recruited from primary healthcare centers in Iran. We collected anthropometric and biochemical data, and calculated the TyG index, classifying participants into quartiles based on their TyG values. Fasting serum glucose (FSG), insulin, and lipid profiles were measured. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). In addition, inflammatory markers including tumor necrosis factor alpha (TNF-α), Interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) long with serum levels of adipokines including leptin, adiponectin, resistin, visfatin, vaspin, and omentin-1 were measured using standardized assays.

Results: Higher TyG quartiles were associated with increased levels of insulin, HOMA-IR, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), TNF-α, leptin, and resistin, and decreased levels of adiponectin (all p < 0.05). There were no significant differences in high-density lipoprotein cholesterol (HDL-c), IL-6, hs-CRP, visfatin, vaspin, or omentin-1. These associations remained significant even after adjusting for age, sex, body mass index (BMI), smoking status, and physical activity.

Conclusion: Our findings suggest that the TyG index reflects not only insulin resistance and atherogenic dyslipidemia, but also low-grade inflammation and adipokine imbalance in patients with MetS. Due to its simplicity and cost-effectiveness, the TyG index could be a useful tool for early metabolic risk assessment and identifying adipose tissue dysfunction.