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BACKGROUND: The understanding of bile acid (BA) and unsaturated fatty acid (UFA) profiles, as well as their dysregulation, remains elusive in individuals with type 2 diabetes mellitus (T2DM) coexisting with non-alcoholic fatty liver disease (NAFLD). Investigating these metabolites could offer valuable insights into the pathophy-siology of NAFLD in T2DM. AIM: To identify potential metabolite biomarkers capable of distinguishing between NAFLD and T2DM. METHODS: A training model was developed involving 399 participants, comprising 113 healthy controls (HCs), 134 individuals with T2DM without NAFLD, and 152 individuals with T2DM and NAFLD. External validation encompassed 172 participants. NAFLD patients were divided based on liver fibrosis scores. The analytical approach employed univariate testing, orthogonal partial least squares-discriminant analysis, logistic regression, receiver operating characteristic curve analysis, and decision curve analysis to pinpoint and assess the diagnostic value of serum biomarkers. RESULTS: Compared to HCs, both T2DM and NAFLD groups exhibited diminished levels of specific BAs. In UFAs, particular acids exhibited a positive correlation with NAFLD risk in T2DM, while the ω-6:ω-3 UFA ratio demonstrated a negative correlation. Levels of α-linolenic acid and γ-linolenic acid were linked to significant liver fibrosis in NAFLD. The validation cohort substantiated the predictive efficacy of these biomarkers for assessing NAFLD risk in T2DM patients. CONCLUSION: This study underscores the connection between altered BA and UFA profiles and the presence of NAFLD in individuals with T2DM, proposing their potential as biomarkers in the pathogenesis of NAFLD.

Summary: Insulin resistance, defined as an impaired biological response to insulin stimulation in target tissues, arises most frequently in the presence of central obesity. Although obesity is generally associated with increased bone mass, recent data challenge this view and, if complicated by T2DM, obese patients are at high risk for fragility fractures. IR may play a key role in this increased fracture risk through effects on bone quality rather than bone quantity. Further understanding of the mechanisms and approaches to prevent osteoporotic fractures in IR-related diseases is needed. Clinical relevance: The dramatic increase in obesity and metabolic syndrome (MetS) over the last half-century has led to a worldwide epidemic of type 2 diabetes mellitus (T2DM) as well as in the incidence of insulin resistance (IR). IR is defined as an impaired biological response to insulin stimulation in target tissues and is primarily related to the liver, muscle, and adipose tissue. The most frequent underlying cause is central obesity, and it is known that excess abdominal adipose tissue secretes increased amounts of free fatty acids, which directly affects insulin signalling, reduces glucose uptake in muscle, and triggers excessive triglyceride synthesis and gluconeogenesis in the liver. When pancreatic β cells are unable to secrete the higher levels of insulin needed, T2DM, the main complication of IR, occurs. Observations: Although obesity is generally associated with increased bone mass, recent data challenge this view and highlight the multifaceted nature of the obesity-bone relationship. Patients with T2DM are at significant risk for well-known complications of diabetes, including retinopathy, nephropathy, macrovascular disease, and neuropathy, but it is clear that they are also at high risk for fragility fractures. Moreover, recent data provide strong evidence that IR may key role in the increased fracture risk observed in both obesity and T2DM. Conclusions: In this concise review article, the role of IR in increased risk of osteoporotic fractures in MetS, obesity, and T2DM is discussed and summarised, including consideration of the need for fracture risk assessment as a 'preventive measure', especially in patients with T2DM and chronic MetS with abdominal obesity. Personalised and targeted diagnostic and therapeutic approaches to prevent osteoporotic fractures in IR-related diseases are needed and could make significant contributions to health outcomes. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is a devastating neurodegenerative condition that exerts a significant global burden. Despite recent efforts, disease modifying therapies remain extremely limited, with a tremendous proportion of patients having to rely on symptomatic treatment only. Epidemiological and pathological overlaps exist between Alzheimer's disease and diabetes mellitus type 2, with people with diabetes mellitus type 2 at a significantly increased risk of developing Alzheimer's disease in the future. Incretin mimetics, also known as GLP-1/GIP receptor agonists, are useful tools licensed for the treatment of diabetes mellitus type 2 which have recently been the subject of news coverage for their off-label use as weight loss medications. Emerging evidence highlights the possible neuroprotective function of incretin mimetics in models of Alzheimer's disease as well as in clinical studies. This review details the pre-clinical and clinical studies that have explored the effectiveness of incretin mimetics to alleviate Alzheimer's disease associated pathology and cognitive impairment, while also highlighting the progress made to examine the effectiveness of these molecules in Parkinson's disease. Should clinical trials prove effective, incretin mimetics may be able to be repurposed and become useful novel tools as disease-modifying treatments for Alzheimer's disease and other neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Introduction: A bidirectional relationship has been observed between type 2 diabetes mellitus and sarcopenia, especially among older adults. While previous studies have reported that imeglimin improves mitochondrial function, they have not assessed its effects on muscle strength in patients with type 2 diabetes. Therefore, we aimed to investigate the effects of imeglimin on muscle strength in patients with type 2 diabetes. Methods: In this prospective cohort study, we recruited consenting patients with type 2 diabetes (20–75 years). Changes in lean body mass (LBM), fat mass, quadriceps muscle strength, and grip strength from baseline (week 0) to week 24 were evaluated and compared between patients treated with imeglimin therapy (group I) and those who did not take imeglimin (controls, group C). Results: We recruited 27 patients treated with imeglimin (group I) and 29 controls (group C), and 50 of them completed the study (group I: n = 23; group C: n = 27). The change in LBM, total body fat mass, or skeletal muscle index from baseline to week 24 did not differ significantly between the two groups. However, group I exhibited a significantly higher percent change in quadriceps knee extension strength from baseline to week 24 than group C (13 ± 19% and 2.1 ± 14%, p = 0.022). Conversely, the difference in percent change in grip strength was not significant. Multivariable analysis showed that imeglimin use was significantly associated with a percent change in quadriceps knee extension strength, independent of age, sex, body mass index, and skeletal mass index (β = 0.325, p = 0.0014). Conclusions: Imeglimin positively affected muscle strength in patients with type 2 diabetes without altering LBM. Therefore, imeglimin exerts a unique effect on skeletal muscles in humans. Further randomized controlled trials are needed to validate these findings. Trial Registration: This research was registered in the University Hospital Medical Information Network (UMIN, UMIN000054715). [ABSTRACT FROM AUTHOR]

Summary: This study aimed to evaluate the efficacy and safety of duodenal–jejunal bypass liner (DJBL) for obesity and type 2 diabetes mellitus. A comprehensive search of electronic databases was conducted up to September 15, 2022. Thirty studies involving 1751 patients were included. At 12 months post‐implantation, the reduction in body mass index (BMI) was 4.8 kg/m2 (95% CI 4.1, 5.5), with an excess weight loss of 41.3% (95% CI 33.4%,49.2%) and a total weight loss of 13.1% (95% CI 10.1%, 16.0%). Significant decrease was observed in HbA1c and fasting glucose, with a standardized mean difference of − 0.72 (95% CI − 0.95, − 0.48) and − 0.62 (95% CI − 0.82, − 0.42), respectively. However, these improvements in weight loss and glycemic control were only partially sustained after explantation. In situ, DJBL significantly improves blood pressure and lipid levels. The pooled early removal rate was 19%, and the incidence of severe adverse events was 17%, including device migration (6%), gastrointestinal hemorrhage (4%), device obstruction (4%), and hepatic abscess (2%). DJBL offers significant improvement in weight loss and glycemic control, as well as cardiovascular parameters while in situ. Further studies are warranted to better understand the long‐term efficacy and safety of DJBL. The benefits of DJBL need to be carefully weighed against the risks in clinical decision‐making. [ABSTRACT FROM AUTHOR]

Aim: To conduct post hoc analyses of the VERTIS CV (NCT01986881) trial to explore the effects of ertugliflozin on serum uric acid (UA) and gout‐related outcomes. Materials and Methods: Participants with type 2 diabetes and atherosclerotic cardiovascular disease were randomised (1:1:1) to placebo, ertugliflozin 5 mg or ertugliflozin 15 mg. Mean UA over time (260 weeks) was evaluated for pooled ertugliflozin versus placebo overall, and by baseline quintile of UA (≤4.3 mg/dL [≤255.8 µmol/L], >4.3–5.1 mg/dL [>255.8–303.4 µmol/L], >5.1–5.8 mg/dL [>303.4–345.0 µmol/L], >5.8–6.9 mg/dL [>345.0–410.4 µmol/L] and >6.9 mg/dL [>410.4 µmol/L]), glycated haemoglobin level, albuminuria status, estimated glomerular filtration rate and KDIGO (Kidney Disease: Improving Global Outcomes in Chronic Kidney Disease) risk category. The effect of ertugliflozin on a composite of gout onset or initiation of anti‐gout medication was assessed. Results: The mean UA levels at baseline were 5.67 and 5.62 mg/dL in the placebo and ertugliflozin groups, respectively. Ertugliflozin reduced UA over Weeks 6–260 compared with placebo, with least squares mean (LSM) changes (95% confidence interval [CI]) from baseline at Week 260 of 0.07 mg/dL (−0.02, 0.15) and −0.19 mg/dL (−0.25, −0.13) in the placebo and pooled ertugliflozin groups, respectively. At Week 260, placebo‐adjusted LSM change (95% CI) from baseline in UA was −0.26 mg/dL (−0.36, −0.16) with ertugliflozin. Ertugliflozin was associated with reductions in UA across baseline UA quintiles compared with placebo. The incidence of the composite of gout‐related outcomes was 84/2539 (3.3%) for placebo and 133/5091 (2.6%) for ertugliflozin (hazard ratio for the composite 0.76 [95% CI 0.580, 1.002]). Conclusions: Ertugliflozin was generally associated with lowering UA overall and across subgroups compared with placebo, and numerically reduced rates of gout‐related outcome events. [ABSTRACT FROM AUTHOR]

Objective: To assess the association between glycated haemoglobin (HbA1c) variability and risk of renal function decline in type 2 diabetes mellitus (T2DM). Research Design and Methods: A comprehensive search was carried out in PubMed, Embase, Web of Science and the Cochrane Library (until 12 March 2024). The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement guidelines were followed for this meta‐analysis. HbA1c variability was presented as indices of the standard deviation (SD), coefficient of variation (CV), HbA1c variability score (HVS) and haemoglobin glycation index (HGI). This meta‐analysis was performed using random‐effect models. Results: Eighteen studies met the objectives of this meta‐analysis. The analyses showed positive associations between HbA1c variability and kidney function decline, with hazard ratio (HR) 1.26 (95% confidence interval [CI] 1.15–1.38) for high versus low SD groups, HR 1.47 (95% CI 1.30–1.65) for CV groups, HR 1.32 (95% CI 1.10–1.57) for HVS groups and HR 1.53 (95% CI 1.05–2.23) for HGI groups. In addition, each 1% increase in SD and CV was linked to kidney function decline, with HR 1.26 (95% CI 1.17–1.35), and 1.13 (95% CI 1.03–1.23), respectively. Also, each 1‐SD increase in SD of HbA1c was associated with deterioration in renal function, with HR 1.17 (95% CI 1.07–1.29). Conclusions: The four HbA1c variability indicators were all positively associated with renal function decline progression; therefore, HbA1c variability might play an important and promising role in guiding glycaemic control targets and predicting kidney function decline progression in T2DM. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients. Method: We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c (<7%; 7%–7.9%; ≥8%) and age (<65; ≥65 years), and then clustered into classes by HbA1c trajectory and CVD incidence over the 12‐year follow‐up period using joint latent class mixture models. We explored the HbA1c trajectories and CVD incidences in each latent class. Multinomial logistic regression was used to compare the baseline characteristics among different latent classes. Results: A total of 128 843 T2DM patients were included with a median follow‐up period of 11.7 years. Ten latent classes were identified in patients with baseline HbA1c ≥ 8% and age <65 years, while seven classes were identified in the other five groups. Among all the identified latent classes, patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, had higher CVD incidences. Male patients, and patients with higher baseline HbA1c and use of antidiabetic drugs were more likely to have a fluctuating HbA1c trajectory. More specifically, patients aged < 65 years with younger age or a smoking habit, and patients aged ≥ 65 years with a longer duration of T2DM were more likely to have a fluctuating HbA1c trajectory. Conclusion: We found that T2DM patients with fluctuating HbA1c trajectories could have a higher CVD risk. Different trajectory‐associated characteristics in age subgroups highlight the need for individualized management of T2DM patients. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of dapagliflozin versus placebo as an add‐on in patients with type 2 diabetes who did not achieve adequate glycaemic control with evogliptin and metformin combination. Patients and Methods: In this multicentre, randomized, double‐blind, placebo‐controlled Phase 3 trial, patients with glycated haemoglobin (HbA1c) levels ≥7.0% (≥53 mmol/mol) and ≤10.5% (≤91 mmol/mol) who had received stable‐dose metformin (≥1000 mg) and evogliptin (5 mg) for at least 8 weeks were randomized to receive dapagliflozin 10 mg or placebo once daily for 24 weeks. Participants continued treatment with metformin and evogliptin. The primary endpoint was change in HbA1c level after 24 weeks of treatment from baseline level. Results: In total, 198 patients were randomized, and 195 patients were included in the efficacy analyses (dapagliflozin: 96, placebo: 99). At Week 24, dapagliflozin significantly reduced HbA1c levels. The least squares mean difference in HbA1c level change from baseline after 24 weeks of treatment was −0.70% (−7.7 mmol/mol) (p < 0.0001). The proportion of participants achieving HbA1c <7.0% (≥53 mmol/mol) was higher in the dapagliflozin group than in the placebo group. Compared to placebo, dapagliflozin significantly reduced fasting plasma glucose, mean daily glucose, 2‐h postprandial plasma glucose, fasting insulin, uric acid and gamma‐glutamyl transferase levels, homeostatic model assessment for insulin resistance index, body weight, hepatic steatosis index, and albuminuria. Adiponectin level significantly increased from baseline level after 24 weeks of dapagliflozin treatment. Adverse event rates were similar in the two groups. Conclusion: Dapagliflozin add‐on to evogliptin plus metformin improved glycaemic control and was well tolerated by the target patients. [ABSTRACT FROM AUTHOR]

Hypertension diabetes mellitus is one of the serious complications of hypertension. In this study, ambulatory blood pressure monitoring (ABPM) and ultrasonic cardiogram (UCG) were used to investigate the cardiac changes and its influencing factors in hypertensive patients with type 2 diabetes mellitus. The ABPM, UCG, Hemoglobin A1c (HbA1c) and body mass index (BMI) of patients were examined. The comparison of HbA1c, BMI, gender, age, daytime and nighttime blood pressure, left ventricular mass index (LVMI), left ventricular hypertrophy (LVH), isovolumic relaxation time (IVRT) and E/A ratio were made between the two groups. The cardiac function of control group was better than that of group B, while that of group B was better than group A. The cardiac index level in group B was better than that in group A, but lower than that in control group. The LVMI in group A was clearly higher than group B and control group, and the incidence of LVH increased. In group A, the nocturnal systolic blood pressure was higher than control group and group B. Nocturnal diastolic blood pressure, daytime diastolic blood pressure and systolic blood pressure in groups A and B were higher than those the control group. The findings indicated that hypertension complicated with type 2 diabetes mellitus can cause degeneration of the heart, and complicated with type 2 diabetes mellitus can accelerate ventricular remodeling and functional deterioration. Hypertension with type 2 diabetes mellitus are more prone to left ventricular damage. [ABSTRACT FROM AUTHOR]

Purpose: Owing to the absence of the most recent evidence on the efficacy and safety of luseogliflozin, our study aimed to conduct a systematic review and meta-analysis of luseogliflozin in patients with type 2 diabetes mellitus. Methods: A comprehensive search of electronic databases like PubMed, Cochrane CENTRAL, and Google Scholar was performed from the inception to the 31st of August 2023 to identify the randomized controlled trials (RCTs) that examined the glucose and body weight lowering efficacy and safety outcomes of luseogliflozin in comparison with control or other active treatments. The fixed or random-effect model was used based on the heterogeneity identified using the I2 statistic and Cochran's Q test. Results: Out of 50 non-duplicate articles identified through database searching, 8 RCTs (11 studies) with 1922 patients were included in this study. The efficacy outcomes like HbA1c (MD: −0.59%; 95% CI: −0.90, −0.29; P < 0.001), FPG (MD: −16.01 mg/dL; 95% CI: −19.46, −12.57; P < 0.001), PPG (MD: −36.63 mg/dL; 95% CI: −43.71, −29.55; P < 0.001) and body weight (MD: −1.66 kg; 95% CI: −2.23, −1.12; P < 0.001) were significantly reduced with luseogliflozin compared to the control group. Regarding the safety outcomes, there was no statistically significant difference between the two groups for hypoglycemia (OR: 1.14; 95% CI: 0.70, 1.84; P = 0.60). However, pollakiuria (OR: 4.08; 95% CI: 1.71, 9.69; P < 0.001) and any ADRs (OR: 2.04; 95% CI: 1.33, 3.14; P < 0.001) were significantly higher in the luseogliflozin group compared to the control. Conclusion: The current study identified a significant improvement in efficacy outcomes of HbA1c, FPG, PPG, and body weight in the luseogliflozin group. Non-significant safety results may be due to a smaller population size and fewer studies. Hence, long-term multicentric RCTs are needed to identify the safety and efficacy in a diversified population. [ABSTRACT FROM AUTHOR]

Aim: To analysis the change of electrogastrogram (EGG) in patients with type 2 diabetes mellitus (T2DM), and evaluate the prevalence of abnormal gastric electrical rhythm (AGER) and its relative influencing factors. Methods: A total of 65 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from Dec. 2020 to Dec. 2021 were included in the cross-sectional study. General information, clinical data, and medical history data of all study subjects, including name, gender, body mass index (BMI), duration of diabetes, anti-diabetic therapies, high blood pressure (HBP) history, smoking history, and medication history, were completely collected. The results of laboratory tests, including biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2 h postprandial C-peptide, 24 h urine total protein (24 hUTP), urine microalbumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were recorded. EGG, Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying ultrasound, fundus examination, carotid artery ultrasonography, cardiac autonomic function test, heart rate variability (HRV) were all examined and recorded as well. According to the results of EGG, the subjects were divided into normal gastric electrical rhythm (NGER) group and abnormal gastric electrical rhythm (AGER) group. Results: (1) Fasting blood glucose (FBG), HbA1c, the presence of diabetic peripheral neuropathy (DPN) and diabetic cardiac autonomic neuropathy (DCAN) were significantly higher in the AGER group (p < 0.05). Low frequency (LF) and high frequency (HF), the indicators of HRV, were significantly lower in the AGER group (p < 0.05). In addition, the prevalence of feeling excessively full after meals, loss of appetite, and stomach or belly visibly larger after meals of gastrointestinal symptoms of gastroparesis were significantly higher in the AGER group (p < 0.05). Multiple logistic regression analysis showed that FBG and the prevalence of DCAN were the independent risk factors. Conclusion: AGER was associated with high FBG and the presence of DCAN. EGG examination is recommended for patients with gastrointestinal symptoms and clues of DCAN. [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to investigate the overall effects of zinc supplementation on lipid profile and body composition such as body weight (BW), body mass index (BMI), triglycerides (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) in patients with type 2 diabetes mellitus (T2DM). Scopus, Web of Science, PubMed, and Embase databases were searched from inception through October, 2023. The I2 and Cochran's Q tests were used to assess heterogeneity between studies. Nineteen RCTs (n = 1357 participants) were included in the meta-analysis. Zinc supplementation significantly reduced TG (WMD = − 17.41 mg/dL; 95% CI: − 22.60, − 12.22; P < 0.001), TC (WMD: − 19.60 mg/dL; 95% CI: − 28.46, − 10.73, P < 0.001), LDL-C (WMD = − 8.80 mg/dL; 95% CI: − 14.80, − 2.81; P = 0.004), and BMI (WMD = − 0.53 kg/m2; 95% CI: − 1.05, − 0.01; P = 0.046) but not BW (WMD: − 0.51 kg, 95 % CI: − 1.99, 0.97, P = 0.498). Moreover, zinc supplementation increased HDL-C (WMD = 4.82 mg/dL; 95% CI: 0.88, 8.76; P = 0.016) in patients with T2DM. Our results propose that zinc supplementation may be an effective strategy for improving lipid profile and body composition in patients with T2DM. [ABSTRACT FROM AUTHOR]

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Background: In supporting primary healthcare in delivering high-quality care for individuals with type 2 diabetes mellitus (T2DM), previous research emphasized strategies to facilitate communication and collaboration between primary healthcare providers and hospitals. This study aims to evaluate the effectiveness of case discussion conferences between specialists from hospitals and primary healthcare providers in China on the optimization of diabetes management and the improvement of patient health outcomes. Methods: This study will be a parallel cluster randomized controlled trial in which primary healthcare institutions in Shouguang city and Shangsi County will be randomly allocated to the intervention and control groups. The intervention will involve regular case discussion conferences where attendants will meet to discuss complex cases with patients diagnosed with type 2 diabetes mellitus, exchange experiences, and seek and provide expert advice. Family doctor teams from primary healthcare institutions and specialists from secondary or tertiary hospitals will engage in these conferences. Data will be collected at baseline and at the 6- and 12-month follow-ups. The primary clinical outcome measures will focus on the changes in the HbA1c and FBG levels of patients under management. The secondary outcomes will include other physiological indicators, such as blood pressure, BMI, and cholesterol. The evaluation will extend to changes in the capabilities and behaviors of primary healthcare providers. Furthermore, the feasibility and adherence of this intervention will be thoroughly assessed. Discussion: This study is designed to generate robust evidence on the effectiveness of case discussion conferences, an interprofessional collaboration strategy, in enhancing diabetes care delivery in primary healthcare, with the ultimate goal of improving patient health outcomes. Trial registration: Chinese Clinical Trial Registry ChiCTR2300078829. Registered on December 19, 2023. https://www.chictr.org.cn/showproj.html?proj=210293 [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions This study aims to investigate the relationship between long‐term visit‐to‐visit within‐person HbA1c variability and hospitalisation outcomes in adults with type 2 diabetes (T2D).We conducted a cohort study at a tertiary hospital in Singapore involving people aged 21 to 101 years with T2D who had ≥3 HbA1c tests over 2 years. HbA1c variability was assessed using coefficient of variation (CV), variability independent of the mean (VIM) and HbA1c variability score (HVS). A 1‐year follow‐up was performed after the last HbA1c measurement to identify all‐cause and potentially avoidable hospitalisations (PAH), categorised as overall, acute, chronic and diabetes composites.The study included 14 923 patients (mean age: 62.9 ± 12.9 years; 55% male). The median HbA1c variability was 8.6% CV (IQR: 5.1–14.3). Higher quartiles of HbA1c variability were associated with greater risks of PAH and all‐cause hospitalisations, independent of glycaemic control. Compared to Q1, for example, the risk ratios and 95% confidence intervals for diabetes‐related PAH based on HbA1c CV were as follows: Q2, 1.32 (0.93–1.88); Q3, 1.65 (1.18–2.31) and Q4, 2.16 (1.54–3.03). For all‐cause hospitalisations, they were as follows: Q2, 0.97 (0.90–1.05); Q3, 1.08 (1.00–1.17) and Q4, 1.16 (1.07–1.26). When stratified by glycaemic control, elevated risk of PAH persisted even in those with optimal glycaemic control. Consistent findings were observed using HbA1c VIM and HVS measures.In individuals receiving care at specialist outpatient clinics of a tertiary hospital, HbA1c variability is associated with a higher risk of PAH. Comprehensive diabetes management strategies addressing both glycaemic control and variability may offer benefits. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between telomere length of peripheral white blood cells and the levels of advanced glycosylation end products, as well as bone mineral density in patients with type 2 diabetes mellitus, and to assess the impact of advanced glycosylation end product levels on telomere length. Methods From May 1, 2023, to May 1, 2024, 174 patients with T2DM who underwent dual-energy X-ray BMD examination at the Department of Endocrinology, Zhengzhou Central Hospital, were selected. T2DM patients were divided into osteoporosis group, osteopenia group, and normal bone mass group based on the T-value in BMD. qPCR method was used to measure telomere length in peripheral blood leukocytes, and ELISA method was used to determine AGEs levels. General patient data were collected along with measurements for blood glucose, blood lipid levels, 25-hydroxy-vitamin D, and other indicators. Bone mineral density was evaluated using dual-energy X-ray imaging while plasma CTX and PINP levels were measured via ELISA. SPSS 26.0 statistical software was utilized to analyze differences and correlations among all indicators. Results （1）The telomere length of OP group, osteopenia group and normal bone mass group was different, and the telomere length of the three groups increased successively. （2） In individuals with type 2 diabetes mellitus, telomere length exhibited a positive correlation with BMD and a negative correlation with CTX and PINP. Plasma AGEs level showed a negative correlation with BMD and a positive correlation with CTX and PINP, while telomere length demonstrated a negative correlation with AGEs level.（3） Telomere length was an independent factor of BMD, and AGEs level was an independent factor of BMD （P < 0.05）. Conclusion The reduction of telomere length and the increase of AGEs in patients with type 2 diabetes are related to the decrease of bone mineral density, and the reduction of telomere length is related to the increase of AGEs. Telomere length of peripheral leucocytes and plasma AGEs level can jointly evaluate the bone metabolism status of T2DM patients. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) remains a global health concern, causing a significant threat to world health. Oral anti‐diabetic drugs play a crucial role in effective management of diabetes. Numerous anti‐diabetic medications have been known for a long period, classified according to their chemical groups but because of their low pharmaceutical cost and long‐term efficacy, sulphonylurea (SU) continues to be a well‐positioned medication with a long history of clinical use in treating type 2 diabetes. Among various available SU, Gliclazide stands out due to its significant reduction in cardiovascular mortality and extremely low rate of severe hypoglycaemia. Numerous synthetic methodologies have been developed to create more efficient pathways resulting in less waste and cheaper manufacturing. The present review aims to summarise some recently reported literature for the synthesis of Gliclazide. We have made an effort to highlight their drawbacks and advantages in this comparative analysis. Here we tried to compile different synthetic routes via various methods to synthesise Gliclazide which will serve as a valuable foundation to make potential modifications to the present inventions. This effort ultimately aims to contribute to the enhancement of the society's health and welfare. [ABSTRACT FROM AUTHOR]

Background: To explore the association of long non-coding RNA (lncRNA) SNHG1/ miR-195 axis with type 2 diabetes mellitus (T2DM) and islet function. Methods: The expression of SNHG1 and miR-195 was measured in T2DM patients and in healthy subjects. Correlation between indciators was evaluated using Pearson correlation analysis. INS-1 cells were used to perform the cell function assays. Insulin secretion by INS-1 was detected using ELISA. Cell counting kit-8 (CCK-8) and flow cytometry was used to detect cell proliferation and apoptosis. Luciferase report assay was to used to verify the target of SNHG1. Results: The expression of SNHG1 was increased and miR-195 level was decreased in the serum of T2DM patients. Both SNHG1 and miR-195 could be biomarkers for T2DM diagnosis. The fasting plasma glucose (FPG) and HbA1c were positively related to SNHG1 and negatively related to miR-195. SNHG1 inhibited insulin secretion, and cell proliferation and promoted apoptosis of INS-1 cells via binding to miR-195. Conclusions: Detection of SNHG1 and miR-195 might predict T2DM. SNHG1 could suppress proliferation and insulin secretion, but promote apoptosis of INS-1 cells via sponging miR-195. [ABSTRACT FROM AUTHOR]

Introduction Objectives Methods Results Conclusion There is a paucity of data evaluating early initiation of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) in patients with diabetes following acute coronary syndrome (ACS) and coronary artery bypass graft surgery (CABG).To describe the efficacy and safety of SGLT2i initiated early after CABG in patients with type 2 diabetes who experienced ACS.This is a retrospective cohort study of patients with type 2 diabetes (T2DM) who experienced ACS and subsequent CABG with follow up at 3 and 12 months. Patients who filled a SGLT2i prescription within 14 days of discharge were allocated to the SGLT2i group and those who did not were included in the no SGLT2i group. The primary efficacy end point was first occurrence of a 4‐point Major Adverse Cardiovascular Event (MACE), and the primary safety end point was a composite of hypoglycemia, hypotension, diabetic ketoacidosis, acute kidney injury, and urinary tract infection. Secondary end points included a comparative analysis of the primary outcome, 30‐day readmission rates, and subgroup analyses of key populations.A total of 1629 patients were included: 226 received a SGLT2i within 14 days of discharge and 1403 did not. At 12 months, 8.9% and 15.3% of patients experienced MACE in the SGLT2i and no SGLT2i groups, respectively (adjusted Hazard Ratio [aHR] 0.65, 95% confidence interval [CI] 0.41–1.04). The primary safety outcome occurred in 12.0% of the SGLT2i group and 19.1% of the no SGLT2i group at 12 months (aHR 0.68, 95% CI 0.45–1.01).Early initiation of SGLT2i use was not associated with a reduction in MACE in patients with T2DM who experienced ACS and underwent subsequent CABG surgery. However, no apparent safety concerns were identified. Adequately powered trials are required to confirm this finding. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Methods Results Conclusion Individuals with type 2 diabetes are at risk of delaying or not performing diabetes health promotion self‐care behaviours because of their social or self‐stigmatization.The study aimed to reveal the effect of stigmatization on diabetes health promotion self‐care behaviours and predictors of stigma and diabetes health promotion self‐care behaviours in individuals with type 2 diabetes.This cross‐sectional study included 235 individuals with type 2 diabetes. The Diabetes Stigma Assessment Scale (DSAS) and Diabetes Health Promotion Self‐Care Scale (DHPSCS) were used for data collection.There was a significant, negative correlation between the DSAS and DHPSCS scores. High mean scores on the DSAS and its subscales treated differently, blame/judgement and self‐stigma were predictors of a negative effect on diabetes self‐care behaviours. Poor health status, alcohol intake and diabetes complications are predictive of stigma. Insulin use and self‐monitoring blood glucose are predictors of self‐care behaviours.Stigma negatively affects diabetes self‐care behaviours in individuals with type 2 diabetes. Nurses could provide education on improvement of health status, harms of alcohol intake and management of diabetes complications. Counselling for coping with stigma and performing self‐care could be provided. Nurses could organize interventions to raise awareness about diabetes in society. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion The study aimed to assess the impact of varying degrees of initial serum sodium change among patients with type 2 diabetes (T2D) starting sodium–glucose cotransporter‐2 inhibitor (SGLT2i) therapy and their subsequent clinical outcome.We used medical data from a multicentre health care provider in Taiwan and recruited 4400 patients with T2D with baseline normal serum sodium (135–145 mmol/L) and follow‐up serum sodium measures available after 3 months of SGLT2i treatment from 1 June 2016 to 31 December 2021.After a median of 2.9 (2.4, 3.4) months of SGLT2i treatment, overall, there was a minimal change in serum sodium levels (from 139.6 ± 2.4 to 139.5 ± 3.7 mmol/L). Most patients (87.8%) maintained normal sodium levels, while 8.6% (n = 378) experienced hyponatraemia (<135 mmol/L) and 3.6% (n = 158) hypernatraemia (>145 mmol/L). Factors independently associated with hyponatraemia included cancer history, chronic lung disease, insulin use, higher glycated haemoglobin, impaired liver function, lower baseline sodium and greater initial decline in kidney function. Conversely, factors linked to hypernatraemia included older age, absence of cancer history, loop diuretic and non‐steroidal anti‐inflammatory drug use, higher baseline sodium and a lesser initial decline in kidney function. Over a median of 26.0 months of follow‐up, hyponatraemia shortly after starting SGLT2i therapy was associated with significantly increased risks of major adverse cardiovascular events [hazard ratio (HR): 2.52; 95% confidence interval (CI): 1.83–3.48], heart failure for hospitalization (HR: 1.66; 95% CI: 1.16–2.37), major adverse renal events (HR: 2.27; 95% CI: 1.73–2.96) and all‐cause death (HR: 2.98; 95% CI: 2.17–4.11) after adjusting for clinically relevant factors. Non‐linear analysis indicated that a more pronounced initial decline in serum sodium levels correlated steeply with higher risks of these adverse events.While most patients with T2D maintain stable serum sodium homeostasis on SGLT2i therapy, a subset may experience dysnatraemic events with potential worse clinical consequences. Physicians should be vigilant about monitoring sodium levels and considering the associated risks when initiating SGLT2i therapy in patients with risk. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a global health problem, and its incidence and complications increase with the duration of the disease and over time. This increase in complications in older patients can lead to disability and a lower quality of life. This study aimed to investigate the rate of diabetes control and complications in older adults. Method: This was a cross-section of an ongoing cohort of patients with type 2 diabetes mellitus (T2DM) aged 65 years and older. The clinical and laboratory characteristics of older adult patients with T2DM in good and intermediate health conditions were collected between 2010 and 2022. Results: A total of 2,770 older adult patients with T2DM were enrolled, including 1,530(55.3%) female and 1,240 (44.7%) male participants. Metabolic syndrome, hypertension, and coronary artery disease were the most common comorbidities, affecting 1,889 (71.4%), 1,495 (54.4%), and 786 (29.2%) patients, respectively. Albuminuria was present in 626 (22.6%) patients, while retinopathy was detected in 408 (14.7%) patients, including 6% with proliferative retinopathy. Most patients were treated with oral antidiabetic agents (88.9%), with metformin being the most prescribed medication (85.6%). Statins were prescribed to 71.8% of the patients. The most prescribed antihypertensive medications were angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, prescribed to 54% and 15% of patients, respectively. The hemoglobin A1c (HbA1c) goal (HbA1c < 7.5%) was achieved in 1,350 (56.4%) patients, and the low-density lipoprotein cholesterol (LDL-C) goal (LDL < 100) was achieved in 1,165 (45.6%) patients. Blood pressure control (BP < 140/90) was achieved in 1,755 (65.4%) patients. All three goals were achieved in 278 (10.3%) patients. There were no significant differences in clinical laboratory results and the patients' characteristics based on gender. Conclusion: The rate of progression of complications in older adult patients is higher than the effectiveness of the treatment, indicating the need for increased social support for this age group. [ABSTRACT FROM AUTHOR]

Aims: To explore the predictive value of the IGF-1/IGFBP-3 ratio for the presence of thyroid nodules in patients with type 2 diabetes mellitus (T2DM). Methods: This observational study prospectively enrolled patients with T2DM at the Second Hospital of Jilin University between May 2021 and January 2022. Thyroid nodule (TN) status was determined by ultrasonography. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of the serum IGF-1/IGFBP-3 molar ratio for TNs. Multivariable logistic regression analysis was conducted to identify risk factors for thyroid nodules in patients with T2DM. Results: A total of 122 patients (mean age ± standard deviation: 52.57 ± 11.71 years; 74 males) were enrolled. 37.7% (n=46) of patients did not have TNs, while 62.3% (n=76) had TNs. The duration of diabetes, age, and HDL-C level were significantly higher in the T2DM group with TNs compared to the group without TNs (all P < 0.05). The area under the ROC curve (AUC) for the combination of IGF-1, IGFBP-3, and the serum IGF-1/IGFBP-3 molar ratio in predicting TNs in T2DM patients was 0.619 (P < 0.001). Additionally, multivariable logistic regression analysis revealed that the duration of diabetes, age, fasting plasma glucose (FPG), fasting insulin (FINS), thyroid-stimulating hormone (TSH), IGF-1, and IGFBP-3 levels were independent risk factors for thyroid nodules, while the serum IGF-1/IGFBP-3 molar ratio level was an independent protective factor for thyroid nodules in patients with T2DM (all P < 0.05). Conclusion: The combination of IGF-1, IGFBP-3, and the serum IGF-1/IGFBP-3 molar ratio may have a better predictive value for TNs in T2DM patients than using any single marker alone. The duration of diabetes, age, FPG, FINS, TSH, IGF-1, IGFBP-3, and the serum IGF-1/IGFBP-3 molar ratio levels were independently associated with thyroid nodules in patients with T2DM. [ABSTRACT FROM AUTHOR]

Studies investigating the association between type 2 diabetes mellitus and central adiposity are lacking. Therefore, this study aimed to investigate trends in type 2 diabetes mellitus stratified by central adiposity using waist-to-height ratio (WHtR). Trends in type 2 diabetes mellitus were examined by central adiposity, using WHtR, with data from the Korea National Health and Nutrition Examination Survey (2005–2022). Individuals aged 30 years and over who participated in the survey were selected. Type 2 diabetes mellitus was identified based on serum glucose or HbA1c levels, the use of diabetes medications, or a prior diagnosis by a physician. Weighted β-coefficients or odd ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess changes in disease prevalence. A total of 79,368 participants were included in the database (female: 45,163 [56.9%]). from 2005 to 2022, the prevalence of type 2 diabetes mellitus increased from 3.3 to 5.8% in the healthy central adiposity group, from 11.2 to 17.1% in the increased central adiposity group, and from 18.0 to 26.7% in the high central adiposity group. Males, older population, lower education level, lower household income, and smoking are associated with a higher risk of type 2 diabetes. In the high central adiposity group, overweight and obese individuals had higher susceptibility than underweight or normal-weight individuals, with ORs of 5.85 (95% CI, 2.54–13.47) and 8.24 (3.79–17.94), respectively. The prevalence of type 2 diabetes mellitus has increased in all central adiposity groups in the past decade. This underscores the need for tailored interventions to address disparities and improve diabetes management in at-risk populations. [ABSTRACT FROM AUTHOR]

Recently, molecular hybridization strategy has paved a way to develop novel lead compounds for the α‐amylase targeted antidiabetic therapy. In this study, we disclosed a series of new hybrids of thiazolidine‐2,4‐diones with 2‐chloroquinoline‐3‐yl moiety as potential antidiabetic agents. The molecular structures of all the synthesized hybrids (15a–n) were confirmed by spectroscopic studies (FT‐IR, ESI‐MS, 1H, 13C NMR, and elemental analysis). When in vitro antidiabetic evaluation of these agents was carried out in a dose‐dependent manner, it was revealed that several compounds (15f–h, 15j, and 15n) were endowed with significant antidiabetic activities and exhibited more than 50% α‐amylase inhibition at a dose of 50 µg/mL. Particularly, hybrid 15n was found to be more potent than acarbose with 95% inhibition of α‐amylase and IC50 of 5.00 ± 0.18 µM under given conditions. Further, it was demonstrated that 15n bearing 2‐chloroquinolinyl and thiazolidin‐2,4‐dione scaffolds functionalized with 3‐OMe and 4‐OH groups was not only able to effectively bind with α‐amylase receptor site with best docking score (−9.644 kcal/mol) but also possessed drug‐likenesses properties with no violations of Lipinski rule. Overall, this study discovered new 2‐chloroquinolinyl‐thiazolidine‐2,4‐diones hybrids as novel α‐amylase inhibitors and compound 15n as promising lead for its further development as antidiabetic agent. [ABSTRACT FROM AUTHOR]

Purpose: To determine new-onset or worsening T2DM risk in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving abiraterone acetate (AA) vs. enzalutamide (ENZA) in England. Methods: Records of patients on AA and/or ENZA (2015−2021) were analysed retrospectively from UK- or England-wide databases and data sets. The primary endpoint was new-onset or worsening T2DM, analysed using a Cox model. Results: Of 1382 patients, 84 (6.1%) met the primary endpoint; 42 of 826 patients (5.1%) received ENZA and 42 of 556 patients (7.6%) received AA. Among patients without baseline T2DM (n = 1049), 50 developed new-onset T2DM: 24 (3.9%) on ENZA and 26 (5.9%) on AA. Among patients with baseline T2DM (n = 333), 34 (10.2%) had worsening T2DM: 18 (8.3%) on ENZA and 16 (13.8%) on AA. Patients on ENZA had longer median follow-up (445 vs. 408 days) and treatment duration (164 vs. 139 days) than those on AA, who were also more likely to have new-onset or worsening T2DM than those on ENZA (HR: 1.8; 95% CI: 1.4–2.7; P = 0.0101). The number needed to harm for an additional patient to experience new-onset or worsening T2DM when receiving AA instead of ENZA was 40 overall, 50 in patients without baseline T2DM, and 18 in patients with baseline T2DM. Conclusion: Patients with mCRPC receiving AA were more likely to experience new-onset or worsening T2DM than those on ENZA, despite having a shorter treatment duration. Further research is required to substantiate these findings in earlier disease settings with longer treatment duration. [ABSTRACT FROM AUTHOR]

Background: Endocrine function in patients with type 2 diabetes (T2DM) typically differs from those with normal glucose tolerance (NGT). However, few epidemiologic studies have explored how these differences impact the association between exposure to polychlorinated biphenyls (PCBs) and vitamin D levels. Methods: This study included 1,705 subjects aged 18–79 years from the Henan Rural Cohort [887 NGT and 818 T2DM]. Linear regression was applied to evaluate the associations between PCB exposure and vitamin D levels. Quantile g-computation regression (QG) and Bayesian kernel machine regression (BKMR) were applied to evaluate the impact of PCB mixtures on vitamin D levels. Interaction effects of ΣPCBs with HOMA2-%β and HOMA2-IR on vitamin D levels were assessed. Results: Plasma ΣPCBs was positively associated with 25(OH)D2 in the NGT group (β = 0.060, 95% CI: 0.028, 0.092). Conversely, in T2DM group, ΣPCBs was negatively associated with 25(OH)D3 and 25(OH)D (β = -0.049, 95% CI: -0.072, -0.026; β = -0.043, 95% CI: -0.063, -0.023). Similarly, both QG and BKMR analysis revealed a negative association between PCB mixture exposure and vitamin D levels in the T2DM group, contrary to the results observed in the NGT groups. Furthermore, the negative association of ΣPCBs with 25(OH)D2 and 25(OH)D disappeared or changed to a positive association with the increase of HOMA2-%β levels. Conclusions: These findings suggest that decreased β cell function may exacerbate the negative effects of PCB exposure on vitamin D levels. Recognizing T2DM patients' sensitivity to PCBs is vital for protecting chronic disease health. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia, a severe mental disorder, is often complicated by Type 2 Diabetes Mellitus (T2DM), which can further impact patients' psychological health. This study investigated the differences in eating attitudes, depression, and insight between schizophrenic patients with and without comorbid T2DM and explored the correlations among these factors to provide empirical support for clinical interventions. Methods: This case-control study was conducted in Guangdong Province, China. From December 2022 to May 2023, a total of 300 hospitalized patients with schizophrenia (92 with comorbid T2DM and 208 without T2DM) were recruited. Data were collected using the Personal Information Form, Eating Attitudes Test (EAT-26), Hamilton Depression Scale (HAMD), and Insight and Treatment Attitudes Questionnaire (ITAQ). Statistical analyses, including t-tests, ANOVA, and multiple linear regression, were performed to examine differences and predictive factors of eating attitudes among patients. This study was approved by the Ethics Committee of the Affiliated Brain Hospital of Guangzhou Medical University (approval number: 2020028), and written informed consent was obtained from all participants. Results: Patients with schizophrenia and comorbid T2DM exhibited significantly higher risks of eating disorders (EAT-26: 12.54 ± 9.77 vs. 9.07 ± 7.90, P=0.003), more severe depression (HAMD: 14.71 ± 7.36 vs. 11.80 ± 6.04, P=0.001), and poorer insight (ITAQ: 10.46 ± 6.01 vs. 12.16 ± 6.09, P=0.025) compared to those without T2DM. Regression analysis revealed that gender, weekly exercise frequency, depression, and insight were significant predictors of eating attitudes among patients with T2DM. For patients without T2DM, weekly exercise frequency, smoking status, and insight were significant predictors. Conclusion: Schizophrenic patients with comorbid T2DM are facing increasing risks related to eating attitudes, depression, and insight which highlight the need for targeted interventions. Regular psychological assessment and tailored support strategies might improve their mental health and quality of life. Future research should focus on longitudinal studies to clarify causal relationships and develop more effective interventions. [ABSTRACT FROM AUTHOR]

Introduction: In patients with rheumatoid arthritis (RA), the increased risk of concomitant type 2 diabetes mellitus (T2D) is an important contributor to increased mortality and decreased quality of life; however, the mechanisms and pathogenetic factors remain unknown. Methods: In this study, we aimed to assess the risk factors for T2D in patients with RA. We recruited 206 healthy controls and 488 patients with RA, 160 of whom had comorbid T2D. General clinical information, disease characteristics, and circulating lymphocyte levels detected using modified flow cytometry were collected from all participants. Logistic regression models adjusted for confounders were fitted to estimate the risk factors of T2D in patients with RA. Results: The incidence of RA in patients with T2D was 15.6%. Patients with RA and T2D had a longer disease duration, higher BMI, and a higher incidence of hypertension and a family history of diabetes than those with RA but no T2D. The absolute numbers of T helper 2 cell (Th2) and Regulatory T cells (Treg) decreased in patients with RAandT2D, which led to an increase in the ratios of Th1/Th2 and Th17/ Treg cells. Multivariate logistic regression analysis showed that a family history of diabetes, a higher incidence of hypertension, higher neutrophil-lymphocyte ratio (NLR) levels, lower platelet-lymphocyte ratio (PLR) levels, and fewer circulating Th2 and Treg cells were associated with an increased risk of T2D in patients with RA. Discussion: The levels of peripheral lymphocytes, especially Th2 and Treg cells, are closely related to the occurrence ofT2D in patients with RA; however, the influence of body mass index (BMI), family history of diabetes, and systemic inflammation should not be ignored. [ABSTRACT FROM AUTHOR]

Background: Although liraglutide has established advantages in treating patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS), there are still some patients with lower responsiveness to liraglutide. The objective of the study was to identify the predictors of response to liraglutide in patients with T2DM and MS. Methods: This retrospective cohort study included patients diagnosed with T2DM and MS who received liraglutide treatment as a part of their diabetes management for a minimum of six months. The participants were stratified into two groups: responders (HbA1c reduction=1.0% and weight loss=3%) and nonresponders. The discrepancies in baseline data between the two groups were analyzed, containing comedications, test parameters, and basic profiles. The affecting factors of response to liraglutide by Logistic regression analysis were performed, and the predictive ability of the identified factors was evaluated by plotting a receiver operating characteristic (ROC) curve. Results: A total of 417 patients with T2DM and MS were examined and followed up according to the inclusion criteria, and 206 patients completed the follow-up; 105 (50.97%) were responders and 101 (49.03%) were non-responders to liraglutide. The binary logistic regression analysis identified baseline HbA1c, baseline BMI, and the duration of T2DM as significant predictors of glycemic and weight responses to liraglutide (P <0.05). The area under the curve of the ROC for the three predictors of liraglutide response after 6 months of treatment was 0.851 (95% confidence interval: 0.793 - 0.910). Conclusion: The baseline HbA1c, baseline BMI, and duration of T2DM were shown to be predictive factors of glycemic and weight improvements in patients with T2DM and MS treated with liraglutide, and had good predictive power. [ABSTRACT FROM AUTHOR]

Objective To explore the status and influencing factors of self-management in community patients with type 2 diabetes mellitus based on socio-ecological model. Methods From Auguast to December, 2023, a total of 225 patients with type 2 diabetes mellitus were recruited from several communities in Nanjing and were investigated with a basic information questionnaire, the Diabetes Knowledge Test, the Diabetes Man- agement Self-efficacy Scale and the Summary of Diabetes Self Care Activities based on socio-ecological model. Results The average score of self-management was (47.94±12.91) socre, with a indicator of 62. 26%. Educa- tion level. hospitalizations, self-provided glucometer, potation, self-efficacy, medical support, community envi- ronment.geographical position are the main influencing factors of the status of self-management, which could explain 45.0% of the total variation. Conclusion The status of self-management in community patients with type 2 diabetes mellitus is mediocre and influenced by factors at multiple levels of socio-ecological model. To improve the awareness and ability of self-management in community patients with type 2 diabetes mellitus. health departments should comprehensively take various influencing factors into consideration, and carry out pertinent and individualized health education and interventions for them. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To explore the association between the non‐high‐density lipoprotein cholesterol (HDL‐C)/HDL‐C ratio (NHHR) and the risk of major adverse cardiovascular events (MACEs) and overall mortality in patients with type 2 diabetes mellitus (T2DM).NHHR, calculated as (total cholesterol – HDL‐C)/HDL‐C, was evaluated in 10,188 participants. Cox proportional hazard regression models were employed to assess the association of NHHR with future risk of MACEs and overall mortality. Restricted cubic spline analysis, smooth curve fitting and piecewise regression models were utilized to explore the non‐linear correlation and establish the threshold. Subgroup and interaction analyses verified the robustness of the findings. The area under the receiver operating characteristic area under the curve assessed the additional predictive value of NHHR beyond conventional risk factors.After adjusting for confounding factors, each 1‐unit increase in NHHR was associated with a 12% increased risk of MACEs (hazard ratio [HR]: 1.12, 95% confidence interval [CI]: 1.07–1.16; p < 0.0001), a 5% increase in overall mortality (HR: 1.05, 95% CI: 1.01–1.10; p = 0.0256), a 10% increase in cardiovascular disease mortality (HR 1.10, 95% CI: 1.03–1.18; p = 0.0074), an 12% increase in non‐fatal myocardial infarction (HR: 1.12, 95% CI: 1.05–1.18; p = 0.0002), and an 11% increase in non‐fatal stroke (HR: 1.11, 95% CI: 1.02–1.20; p = 0.0123). Analyses showed a non‐linear relationship between NHHR and MACEs in patients with T2DM (non‐linearity p < 0.001). A two‐stage linear regression model identified a threshold for MACEs at 6.28. Integration NHHR into the conventional model significantly enhanced predictive accuracy for MACEs.NHHR is a predictor of the risk of developing MACEs and overall mortality in patients with T2DM, with higher NHHR values independently associated with increased future MACE risks after full adjustment for confounders. [ABSTRACT FROM AUTHOR]

The prevalence of T2DM has been increasing dramatically over recent decades, about 537 million people in 2021. LADA type diabetes, a subtype of diabetes that exhibits characteristics of both T2DM and autoimmune beta‐cell destruction similar to T1DM, but with a later onset. The aim of this study is to analyze the main research field on LADA type, including analysis of countries, institutions, journals, authors, and keywords. This research utilized a descriptive bibliometric design. We collected and analyzed data from 672 publications indexed in the Web of Science and Scopus databases, covering the period from 1994 to January 2024. The bibliometric analysis included English‐language research articles that involved studies on patients with LADA type diabetes, aged 18 years or older. RStudio and the Bibliometrix R package were used for data merging and for performing statistical and visual analyses. The annual publication shows an upward trend over the period, with the highest number of publications per year in 2021. The study showed that China leads in the number of articles, with 101 papers published. The United Kingdom demonstrates significant international collaborations, particularly with Germany. The top institutions in terms of the number of published articles are the Norwegian University of Science and Technology in the Kingdom of Norway, followed by the Central South University in China. Tuomi has shown significant long‐term publication impact, while Zhou ranks among the most frequently cited authors. Diabetes Care is one of the most important scientific journals in diabetology with the highest impact factor of 16.2. This abstract summarizes a comprehensive bibliometric analysis that provides insights into the global research field of LADA type, underscoring the importance of international collaboration and the significant contributions of leading countries and institutions in shaping our understanding of this complex subtype of diabetes. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of empagliflozin in reducing all‐cause mortality (ACM), hospitalization for heart failure (HHF), myocardial infarction (MI), stroke, cardiovascular mortality (CVM), and end‐stage renal disease (ESRD) in routine clinical practice in the Nordic countries of the Empagliflozin Comparative Effectiveness and Safety (EMPRISE) study. Methods: This noninterventional, multicountry cohort study used secondary data from four Nordic countries (Denmark, Sweden, Finland, and Norway). Propensity score (PS) matched (1:1) adults with type 2 diabetes (T2D) initiating empagliflozin (a sodium‐glucose cotransporter‐2 inhibitor) during 2014–2018 who were compared to those initiating a dipeptidyl peptidase‐4 inhibitor (DPP‐4i). Cox proportional hazards regression modelling was used to assess the risk for ACM, HHF, MI, stroke, CVM, and ESRD. Meta‐analyses were conducted and hazard ratios (HRs) with 95% confidence intervals (CIs) from random‐effects models were calculated. Results: A total of 43,695 pairs of PS‐matched patients were identified. Patients initiating empagliflozin exhibited a 49% significantly lower risk of ACM (HR: 0.51, 95% CI 0.40–0.64) compared to DPP‐4i. Additionally, empagliflozin was associated with a 36% significantly lower risk of HHF (HR: 0.64, 95% CI 0.46–0.89), a 52% significantly lower risk of CVM (HR: 0.48, 95% CI 0.37–0.63), and a 66% significantly lower risk of ESRD (HR: 0.34, 95% CI 0.15–0.77) compared to DPP‐4i. No significant differences were observed in the risk of stroke and MI between patients initiating empagliflozin compared with those initiating a DPP‐4i. Results were generally consistent for subgroups (with/without pre‐existing CV disease or congestive heart failure) and in sensitivity analyses. Conclusion: Empagliflozin initiation was associated with a significantly reduced risk of ACM, HHF, CVM, and ESRD compared with initiation of DPP‐4i in patients with T2D when examining routine clinical practice data from Nordic countries. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate the effects of blood flowrestrictive resistance training (BFR-RT) on improving metabolic abnormalities, blood pressure (BP), obesity, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in middle-aged patients with type 2 diabetes mellitus (T2DM). Method: We conducted a parallel-group, single blind randomized controlled trial. Participants who met the inclusion criteria were randomly divided into control group, BFR-RT group and aerobic exercise (AE) group. Control group received health education and follow-up; Two exercise groups received supervised collective training for a period of six months, three times per week. AE group trained at moderate-intensity for 60 minutes each time, while BFR-RT group trained at low-intensity for 40 minutes each time. The primary outcomes were change in 10-year ASCVD risk index and level, and the secondary outcomes included changes in fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), blood lipids, BP, and obesity level within and across the three groups at baseline, the third and sixth months of intervention. Result: Among 93 individuals (control group, n=31; AE, n=30; BFR-RT, n=32) were analyzed. At baseline, there were no significant differences in various indicators among the three groups (p>0.05). After intervention, the 10-year ASCVD risk index and risk level of both exercise groups significantly decreased compared to the control group and baseline (p<0.05), and the risk reduction became more pronounced over time. In the sixth month of intervention, the 10-year ASCVD risk index in the AE group decreased by 27.40%, and that in the BFRRT group decreased by 26.78%. Meanwhile, apart from lipoprotein (a) and diastolic blood pressure, both exercise groups showed significant improvements in FPG, HbA1c, dyslipidemia, systolic blood pressure, and obesity indicators compared to the control group and baseline (p<0.05). There was no significant difference in various indicators between the two exercise groups (p>0.05). Conclusion: BFR-RT could reduce the 10-year ASCVD risk in middle-aged T2DM patients for by improving metabolic abnormalities, BP and obesity, and its effect was similar to that of moderate-intensity AE. [ABSTRACT FROM AUTHOR]

Background: Secondary osteoporosis is associated with type 2 diabetes mellitus (T2DM), and there is conflicting evidence regarding the relationship between insulin-like growth factor-1 (IGF-1) and bone mineral density (BMD) in different populations. The objective of this study was to investigate the relationship between serum IGF-1 levels and BMD in patients with T2DM. Method: A retrospective cross-sectional study was performed on a cohort of 363 patients with T2DM, comprising men aged over 50 and women who are postmenopausal. Those with no significant medical history or medication affecting BMD or IGF-1 were considered. Data analyzed included IGF-1 levels, markers of bone metabolism, and measurements of BMD. To account for age and gender variations, we calculated IGF-1 standard deviation scores (IGF-1 SDS) for further investigation. Results: A significant increase in BMD at lumbar spine (LS), femoral neck (FN), and total hip (TH) was observed as IGF-1 SDS tertiles rose. We revealed a nonlinear correlation between IGF-1 SDS and BMD at these sites, with a common inflection point identified at an IGF-1 SDS level of -1.68. Additionally, our multivariate piecewise linear regression analysis highlighted a positive association between IGF-1 SDS and BMD at LS, FN, and TH when IGF-1 SDS exceeded the inflection point (b 0.02, 95% CI 0.01, 0.04 for LS; b 0.02, 95% CI 0.01, 0.03 for FN; b 0.02, 95% CI 0.01, 0.03 for TH). Conversely, below the inflection point, this association was not significant (b -0.04, 95% CI -0.10, 0.01 for LS; b -0.04, 95% CI -0.08, 0.01 for FN; b -0.03, 95% CI -0.08, 0.01 for TH). Conclusion: These findings reveal a nonlinear relationship between IGF-1 SDS and BMD in T2DM patients. Higher serum IGF-1 levels were connected to increased bone density only after surpassing a certain threshold. [ABSTRACT FROM AUTHOR]

Background: Uteroglobin is a multifunctional protein with anti-inflammatory properties. Studies have revealed the importance of inflammation in type 2 diabetes mellitus (T2D) pathogenesis. Here, we investigated the relationship between uteroglobin and T2D. Methods: We performed diagnostic tests for diabetes in subjects who had not been diagnosed with or treated for T2D. We established three groups, containing those with normal glucose tolerance (NGT), prediabetes and T2D, consisting of 80 people each, and compared their uteroglobin levels. In addition, 28 patients newly diagnosed with T2D were treated with metformin for 12 weeks, and 63 patients newly diagnosed with dyslipidaemia during the treatment for T2D were treated with statin for 12 weeks. Results: This study showed that uteroglobin levels were significantly lower in prediabetes and T2D groups than in the NGT group. Uteroglobin levels were not significantly correlated with other metabolic parameters, except BMI, HOMA-b and eGFR. In the group treated with metformin or statin, uteroglobin levels increased after treatment compared to before treatment. Conclusions: Uteroglobin is a sensitive factor that was decreased even in prediabetes and increased upon treatment with drugs with anti-inflammatory effects. Uteroglobin is a potential early biomarker that reflects a chronic inflammatory condition in T2D. [ABSTRACT FROM AUTHOR]

Background: In the ACCORD study, participants with the haptoglobin (Hp) 2–2 phenotype and glycated hemoglobin (HbA1c) ≥ 8.0% had a higher risk of coronary artery disease (CAD) compared to those with HbA1c 7.0–7.9%. However, this association was not observed in participants without the Hp2-2 phenotype. The optimal glycemic target for CAD prevention for the Hp phenotypes remains uncertain and may vary based on demographic and clinical factors. Objective: To investigate how reaching clinically relevant HbA1c targets relates to the risk of CAD in different Hp phenotype groups among a diverse cohort of individuals with T2DM (the Look AHEAD study, HbA1c ≤ 11% at baseline). Methods: Cox regression models with time-varying covariables were used to quantify the association between time-varying achieved HbA1c (< 6.5%, 6.5–6.9%, and ≥ 8.0% compared to 7.0-7.9%), updated at years 1–4, 6, 8, and 10, and incident CAD in the Hp2-2 (n = 1,587) and non-Hp2-2 (n = 2,944) phenotypes separately. Further pre-specified subgroup analyses by age, sex, history of cardiovascular disease (CVD), race, and diabetes duration were performed in each Hp phenotype group separately. Results: Compared with HbA1c 7.0-7.9%, having HbA1c < 6.5% was associated with a 29% lower CAD risk among participants with the non-Hp2-2 phenotype (adjusted HR 0.71, 95% CI 0.55–0.90). In subgroup analyses, this association was present in participants with the non-Hp2-2 phenotype who were male (0.60, 0.44–0.83), who did not have a history of CVD (0.65, 0.47–0.90), who were aged ≥ 65 years (0.64, 0.44–0.94), who were White (0.68, 0.51–0.91), or who had diabetes duration > 10 years (0.58, 0.35–0.95). HbA1c ≥ 8.0% was associated with CAD risk only among participants with the Hp2-2 phenotype who had a history of CVD (1.79, 1.00-3.20). No associations were found between the other HbA1c targets and CAD risk when participants with the Hp2-2 phenotype were grouped together or divided into subgroups. Conclusion: The differences in our results compared to our previous findings may be due to variations in the study populations and factors associated with weight loss, making it difficult to draw definitive conclusions. Our current findings should be considered in the context of hypothesis generation, and ideally, will encourage additional research in this field. [ABSTRACT FROM AUTHOR]

Background: By 2045, it is expected that 693 million individuals worldwide will have diabetes and with greater risk of morbidity, mortality, loss of vision, renal failure, and a decreased quality of life due to the devastating effects of macro- and microvascular complications. As such, clinical variables and glycemic control alone cannot predict the onset of vascular problems. An increasing body of research points to the importance of genetic predisposition in the onset of both diabetes and diabetic vascular complications. Objectives: Purpose of this article is to review these approaches and narrow down genetic findings for Diabetic Mellitus and its consequences, highlighting the gaps in the literature necessary to further genomic discovery. Material and methods: In the past, studies looking for genetic risk factors for diabetes complications relied on methods such as candidate gene studies, which were rife with false positives, and underpowered genome-wide association studies, which were constrained by small sample sizes. Results: The number of genetic findings for diabetes and diabetic complications has over doubled due to the discovery of novel genomics data, including bioinformatics and the aggregation of global cohort studies. Using genetic analysis to determine whether diabetes individuals are at the most risk for developing diabetic vascular complications (DVC) might lead to the development of more accurate early diagnostic biomarkers and the customization of care plans. Conclusions: A newer method that uses extensive evaluation of single nucleotide polymorphisms (SNP) in big datasets is Genome-Wide Association Studies (GWAS). [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of type 2 diabetes mellitus is somewhat associated with lipid metabolism. We aim to assess the impact of lipid-lowering drugs (HMGCR inhibitors, PCSK9 inhibitors, and NPC1L1 inhibitors) on type 2 diabetes mellitus and its complications through a two-sample Mendelian randomization (MR) study. Method: We identified suitable genetic instruments from the GWAS database that represent the expression levels of three genes, interpreting reduced genetically proxied gene expression as indicative of lipid-lowering drug use. We evaluated the causal relationships among these variables employing a two-sample Mendelian randomization approach, with the Inverse Variance Weighted (IVW) analysis serving as the primary method. Coronary artery disease was utilized as a positive control to validate the reliability of the selected genetic instruments. Result: Increased genetically proxied HMGCR expression is significantly associated with a reduced risk of type 2 diabetes mellitus (OR = 0.64, 95%CI = 0.55–0.74), which was replicated in the FinnGen study with consistent results (OR = 0.65, 95%CI = 0.53–0.80). Increased genetically proxied HMGCR expression is associated with a reduced risk of diabetic retinopathy (OR = 0.23, 95%CI = 0.12–0.44) and diabetic nephropathy (OR = 0.35, 95%CI = 0.17–0.71). In contrast, increased genetically proxied PCSK9 expression is associated with a decreased risk of diabetic coma (OR = 0.70, 95%CI = 0.50–0.98), diabetic neuropathy (OR = 0.24, 95%CI = 0.14–0.42), diabetic retinopathy (OR = 0.67, 95%CI = 0.48–0.96), diabetic cardiovascular diseases (OR = 0.62, 95%CI = 0.38–0.99), and diabetic nephropathy (OR = 0.62, 95%CI = 0.41–0.95). Conclusions: This Mendelian randomization study suggests an association between HMGCR and the pathogenesis of type 2 diabetes mellitus, with increased genetically proxied HMGCR expression reducing the risk of type 2 diabetes mellitus, while PCSK9 and NPC1L1 show no significant association with type 2 diabetes mellitus. These findings may offer more reasonable lipid-lowering drug options for patients with dyslipidemia. Highlights: • Many studies have found that certain lipid-lowering drugs increase the risk of some diseases. • Observational study finds HMGCR inhibitors increase the risk of type 2 diabetes mellitus. •HMGCR inhibitor use increased the risk of type 2 diabetes in both of two different populations. [ABSTRACT FROM AUTHOR]

Diabetes self-care activities are essential for achieving optimal glycemic control. However, little investigation has been conducted in Ethiopia to evaluate the relationship between the rate glycemic controland self-care activities among patients with type 2 diabetes mellitus (T2DM). Therefore, this study was conducted to assess self -care activities and their association with glycemic control among patients with T2DM in Northwest Ethiopia general hospitals. This multicenter cross-sectional study was conducted in Northwest Ethiopia general hospitals diabetic clinics. Diabetes self-care activities were measured using the Amharic version of the Summary of Diabetes Self-Care Activities (SDSCA-Amharic). Glycated hemoglobin (HbA1c) were used to assess the rate of glycemic control. A linear regression model was used to identify predictors of self-care activities and glycemic control. P-value of < 0.05 at 95% confidence interval (CI) was considerd as statistically significant. Of 413 participants included in the final analysis, two-thirds (66.3%) had poor glycemic control, with a mean HbA1c of 7.94% (SD = 1.75). Blood glucose testing was the most important self-care activity domain for predicting better glycemic control [β=-0.36, 95% CI (-0.48, -0.24); P = 0.0001] followed by diet [β=-0.29, 95% CI (-0.39, -0.083); P = 0.0001], foot-care [β=-0.28, 95% CI (-0.3, -0.061); P = 0.003], and physical activity [β=-0.27, 95% CI (-0.29, -0.056); P = 0.004], respectively. Moreover, unable to read and write [β = 0.72, 95% CI (0.57, 3.8); P = 0.037], overweight [β = 0.32, 95% CI (0.011, 0.62); P = 0.042], obesity [β = 0.67, 95% CI (0.39, 0.94); P = 0.0001], and low level of medication adherence [β = 0.7, 95% CI (0.39, 1.1); P = 0.0001] were significant predictors of poor glycemic control. Previous diabetes education [β=-0.88, 95% CI (-1.2, -0.57); P=0.0001] was a significant predictor of good glycemic control. The prevalence of poor glycemic control and poor self-care activities were high among patients with T2DM. Self-care activities were independent predictors of glycemic control among patients with T2DM. Therefore, management interventions for patients with T2DM should focus on improving self-care activities and other predictor variables. [ABSTRACT FROM AUTHOR]

Objective: Type 2 diabetes mellitus (T2DM) over time predisposes to inflammatory responses and abnormalities in functional brain networks that damage learning, memory, or executive function. The hippocampus is a key region often reporting connectivity abnormalities in memory disorders. Here, we investigated peripheral inflammatory responses and resting-state functional connectivity (RSFC) changes characterized of hippocampal subregions in type 2 diabetes-associated cognitive decline (T2DACD). Methods: The study included 16 patients with T2DM, 16 patients with T2DACD and 25 healthy controls (HCs). Subjects were assessed for cognitive performance, tested for the expression of inflammatory factors IL-6, IL-10 and TNF-α in peripheral serum, underwent resting-state functional magnetic resonance imaging scans, and analyzed for RSFC using the hippocampal subregions as seeds. We also calculated the correlation between cognitive performance and RSFC of hippocampal subregion, and analyzed the significantly altered RSFC values of T2DACD for Receiver Operating Characteristic (ROC) analysis. Results: T2DACD patients showed a decline in their ability to complete cognitive assessment scales and experimental paradigms, and T2DM did not show abnormal cognitive performance. IL-6 expression was increased in peripheral serum in both T2DACD and T2DM. Compared with HCs, T2DACD showed abnormalities RSFC of the left anterior hippocampus with left precentral gyrus and left angular gyrus. T2DM showed abnormalities RSFC of the left middle hippocampus with right medial frontal gyrus, right anterior and middle hippocampus with left precuneus, left anterior hippocampus with right precuneus and right posterior middle temporal gyrus. Compared with T2DM, T2DACD showed abnormalities RSFC of the left posterior hippocampus and right middle hippocampus with left precuneus. In addition, RSFC in the left posterior hippocampus with left precuneus of T2DACD was positively correlated with Flanker conflict response time (r=0.766, P=0.001). In the ROC analysis, the significantly altered RSFC values of T2DACD achieved significant performance. Conclusions: T2DACD showed a significant decrease in attentional inhibition and working memory, peripheral pro-inflammatory response increased, and abnormalities RSFC of the hippocampal subregions with default mode network and sensory-motor network. T2DM did not show a significant cognitive decline, but peripheral pro-inflammatory response increased and abnormalities RSFC of the hippocampus subregions occurred in the brain. In addition, the left precuneus may be a key brain region in the conversion of T2DM to T2DACD. The results of this study may provide a basis for the preliminary diagnosis of T2DACD. [ABSTRACT FROM AUTHOR]

ShenZhu TiaoPi granule (STG) is a compound prescription that is used in Chinese medicine for the treatment of type 2 diabetes mellitus (T2DM). Previous studies have indicated a hypoglycaemic effect, but the underlying mechanism remains unclear. Goto-Kakizaki (GK) rats were used to establish an in vivo T2DM model (Mod). The metformin (Met) and STG treatment time was 12 weeks. Fasting blood glucose (FBG) and insulin levels and the area under the glucose curve (GAUC) were measured. Intestinal pathology and permeability were observed. Microbial diversity analysis and metabolomics were used to investigate the underlying mechanisms. Compared with the Con group, the T2DM Mod group presented significant differences in weight, FBG, GAUC, and homeostasis model assessment-insulin resistance (HOMA-IR) indices (p < 0.01). Met and STG improved these indicators (p < 0.01). The pathological morphology and zonula occludens 1 protein levels in the intestines of the Mod group of rats were altered, leading to increases in the lipopolysaccharide (LPS) and interleukin-1ß (IL-1ß) levels. In the Met and STG groups, the intestinal conditions improved, and the LPS and IL-1ß levels significantly decreased (p < 0.01). Changes in the gut microbiota and metabolites occurred in the Mod group. In the STG group, the abundance of Intestinimonas increased, and the abundance of Eubacterium coprostanoligenes decreased significantly (p < 0.05). Moreover, STG also altered 2-deoxyglucose, beta-muricholic acid and dioxolithocholic acid production. In addition, the main metabolic pathways affected by STG were bile acid biosynthesis and cholesterol metabolism. Intestinimonas, D-maltose_and_ alpha-lactose may be potential biomarkers for the effects of STG. STG alleviates hyperglycaemia via the gut microbiota and metabolites in GK rats. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by hyperglycemia and insulin resistance, often leading to complications in multiple systems, including neuropathy, nephropathy, retinopathy, and bone diseases. Osteoporotic fractures are particularly concerning public health issues due to their high incidence, significant fatality rate, and substantial consumption of medical resources. Compared to non ⁃ diabetic individuals, patients with T2DM have an elevated risk of fragility fractures. Despite often having normal or increased bone density, the primary cause of this increased fracture risk is impaired bone mass. The mechanisms underlying increased bone fragility in T2DM patients are complex and multifactorial, involving obesity, hyperglycemia, insulin resistance, oxidative stress, microvascular complications, and the accumulation of advanced glycation end products. These factors can lead to alterations in bone metabolism, structure, and strength. Additionally, other factors, such as hypoglycemia and the associated increased risk of falls, as well as the direct effects of certain antidiabetic medications on bone and mineral metabolism, may further contribute to the heightened fracture risk in this population. This review provides a concise overview of the mechanisms by which these factors influence bone fragility in patients with T2DM. [ABSTRACT FROM AUTHOR]

Objective To construct and validate a risk nomogram model for sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Methods Totally 3 558 elderly T2DM patients admitted to the outpatient department of Shangrao People's Hospital from January 2020 to December 2023 were collected. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia (AWGS) criteria, categorizing patients into a sarcopenia group (1 003 cases) and a non-sarcopenia group (2 555 cases). Baseline data between the two groups were compared. Patients were randomly divided into a training group (2 376 cases) and a validation group (1 182 cases) at a 2:1 ratio. Lasso regression was used to select variables, and multivariate logistic regression analysis was performed to identify factors influencing sarcopenia in elderly T2DM patients. An R language-based nomogram prediction model was established, and the model's discrimination and accuracy were evaluated using receiver operating characteristic (ROC) curves and Hosmer-Lem show curves. Additionally, external validation was conducted with 411 elderly T2DM patients admitted to the hospital from January to May 2024. Results Among the 3 558 T2DM patients, 1 003 (28.19%) were diagnosed with sarcopenia. Lasso regression identified seven predictive variables for sarcopenia in T2DM, including age, duration of diabetes, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2h PBG), glycated hemoglobin (HbA1c), history of hypertension, and presence of diabetic complications. Multivariate logistic regression indicated that age, duration of diabetes, FBG, 2h PBG, and diabetic complications were significant factors, with odds ratios (OR) (95%CI) of 1.049 (1.026-1.072), 1.299 (1.262-1.336), 1.430 (1.248-1.638), 1.588 (1.448-1.742), and 4.203 (3.183-5.550), respectively. The area under the ROC curve (AUC) for predicting sarcopenia in the training and validation groups was 0.898 (95XCI: 0.887-0.910) and 0.880 (95%CI: 0.865-0.895), respectively. The Hosmer-Lem show calibration curve showed good fit (Training group: P=0.929; Validation group: P=0.802; External validation: P=0.773). Conclusion Elderly T2DM patients have a high risk of developing sarcopenia. The nomogram model, based on age, duration of diabetes, FBG, 2h PBG, and diabetic complications, effectively predicts the occurrence of sarcopenia in elderly T2DM patients. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a metabolic disease characterized by hyperglycemia. Type 2 diabetes mellitus patients are known to have mutations in their mitochondrial DNA (mtDNA). mtDNA easily undergoes mutations because it does not have histone proteins for protection and lacks a proofreading mechanism during its replication. The mtDNA mutations T15663C found in type 2 diabetes mellitus patients sufferers with a cataract disease. This mutation was found to occur in the cytochrome b gene, one of the gene in the complex III respiratory chain. In this study we investigate the effect of this mutation on the structure of cytochrome b using molecular dynamics simulations using PDB ID: 5XTE as a template and carrying out simulations for 250 ns. The models of wild type and mutant protein structure were constructed using CHARMM-Gui so that, the protein was looked like in the mitochondrial membrane. The results of the molecular dynamics simulation show that the potential energy of the wild type model is lower than the mutant model, the RMSD value of the wild type model is more stable at 114 - 180 ns, and the RMSF value in the wild type model does not fluctuate as much as the mutant model. In addition, the hydrogen bond (H bond) analysis of the mutant model has a higher H bond number than the wild type model, which means that the mutant model is more rigid. The simulation results were visualized using VMD, and new hydrogen bonds were found in the mutant model. [ABSTRACT FROM AUTHOR]

Background: Individuals with type 2 diabetes mellitus (T2DM) are prone to musculoskeletal complications, particularly in the upper extremities (UE), which can significantly impair their grip strength and UE muscle strength. This review will provide valuable insights for developing optimized exercise interventions aimed at enhancing upper limb functionality and improving patient outcomes. Aim: To determine the effect of different exercise training on grip strength & UE muscle strength in patients suffering from T2DM. Methodology: A comprehensive search from electronic databases was performed based on the selection criteria and 13 randomized controlled trials (RCT's) were included in the study. Mean changes in grip strength and UE muscle strength were the primary outcome measures. Included studies ranked high on the PEDro rating scale and eta‐analysis was performed by Rev Man 5.4 software. Results: Meta‐analysis results indicated that there was a statistically significant improvement in UE muscle strength of experimental group when compared to control group (mean differences [MD] = 2.91, 95% confidence interval = 0.12, 5.71; p = 0.04) with moderate heterogeneity (I2 = 49%, p < 0.07). Grip strength improved significantly in the experimental group when compared to the control group with (MD = 2.93, 95% CL = −0.00, 5.86; p = 0.05) and moderate heterogeneity (I2 = 66%, p < 0.08). Conclusion: This review indicated a positive role of supervised resistance & aerobic exercises on UE muscle strength in patients with T2DM. Due to lack of RCT's, grip strength needs to be explored by further investigations in these patients. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study is to examine the alterations in subcortical brain volume and cortical thickness among individuals diagnosed with Type 2 diabetes mellitus (T2DM) through the application of morphometry techniques and, additionally, to investigate the potential association between these modifications and insulin resistance (IR). Materials and methods: The present cross‐sectional study comprised a total of 121 participants (n = 48 with healthy controls [HCs] and n = 73 with T2DM) who were recruited and underwent a battery of cognitive testing and structural magnetic resonance imaging (MRI). FreeSurfer was used to process the MRI data. Analysis of covariance compared discrepancies in cortical thickness and subcortical brain volume between T2DM and HCs, adjusting for the potential confounding effects of gender, age, education, and body mass index (BMI). Exploratory partial correlations investigated links between IR and brain structure in T2DM participants. Results: Compared with HCs, individuals with T2DM demonstrated a cortical thickness decrease in the right caudal middle frontal gyrus, right pars opercularis, left precentral gyrus, and bilateral superior frontal gyrus. Furthermore, this study for T2DM found that the severity of IR was inversely related to the volume of the left putamen and left hippocampus, as well as the thickness of the left pars orbitalis, left pericalcarine, right entorhinal area, and right rostral anterior cingulate gyrus. Conclusion: The evidence for structural brain changes in T2DM was observed, and alterations in cortical thickness were concentrated in the frontal lobes. Correlations between IR and frontal cortical thinning may serve as a potential neuroimaging marker of T2DM and lead to various diabetes‐related brain complications. [ABSTRACT FROM AUTHOR]