Acta Diabetologica[JOURNAL]
Sun
200 papers
The impact of short maternal height on gestational diabetes.
Crane J, Murphy P, O'Brien D
Acta Diabetol · 2025 Dec · PMID 40616685 · Publisher ↗
AIMS: To evaluate the impact of short maternal height on gestational diabetes, by different body mass index (BMI) classes. METHODS: We performed this population-based retrospective cohort study including individuals with...
AIMS: To evaluate the impact of short maternal height on gestational diabetes, by different body mass index (BMI) classes. METHODS: We performed this population-based retrospective cohort study including individuals with singleton pregnancies delivering January 1st 2012 to December 31st 2019 in the Eastern Health region of the province of Newfoundland and Labrador, Canada. We divided maternal height into three groups: < 25% (short height), 25-75% (average height), and > 75% (tall height). We performed univariate and multivariate regression analyses (adjusting for potential confounders identified in univariate analyses) to determine if short height was an independent predictor of gestational diabetes, stratified by BMI class. RESULTS: We assessed 15,803 pregnancies, with 1062 (6.7%) experiencing gestational diabetes. Among all BMI categories combined, short height was an independent predictor of gestational diabetes (OR = 1.20, 95% CI 1.02-1.41, p = 0.031). In stratified analyses, short height was an independent predictor of gestational diabetes among those with a normal BMI (OR = 1.75, 95% CI 1.23-2.50, p = 0.002) but not an independent predictor in higher BMI classes. CONCLUSIONS: The association between short maternal height and gestational diabetes varies by BMI class. Among those with a normal BMI, short maternal height is associated with the development of gestational diabetes.
High-glucose stimulation triggers early transcription of a panel of proinflammatory mediators in rat Muller glia cells and retina primary explants.
Tundo GR, Atzori MG, Boccaccini A … +10 more , Cavaterra D, Bocedi A, Graziani G, Marini S, Lacal PM, Villa M, Pricci F, Varano M, Parravano M, Sbardella D
Acta Diabetol · 2025 Dec · PMID 40613921 · Publisher ↗
Several preclinical data support a main role of Muller glia, a type of retinal glial cells, in sensing hyperglycemia and, subsequently, acquiring a pro-inflammatory polarization during diabetic retinopathy onset and prog...
Several preclinical data support a main role of Muller glia, a type of retinal glial cells, in sensing hyperglycemia and, subsequently, acquiring a pro-inflammatory polarization during diabetic retinopathy onset and progression. Recently, we reported that stimulation of rat Muller glia cells (rMC1) with high glucose triggers a very early (< 15 min) and atypical signaling cascade, regulated by a Ca-calmodulin/proteasome axis, which induces the nuclear translocation of p65-p50 heterodimer, the principal transcription factor of pro-inflammatory NFkB pathway. In the present study, the repertoire of NF-kB pro-inflammatory genes was early monitored after high-glucose stimulation, in rMC1, as compared to cells stimulated with normal glucose or hyper-osmolar mannitol. The occurrence of an early transcriptional upregulation of most stimulated genes was also verified in rat retina cultures isolated from Sprague-Dawley rats. The overall analysis showed that: (i) high glucose triggers a pro-inflammatory polarization of rMC1 much earlier than previously thought and (ii) this early upregulation recapitulates also in rat retinal culture. Importantly, it has emerged a prominent role played by IL-8 in the early stages of hyperglycemic insult, opening to further studies on its role in primary diabetic retinopathy pathogenesis and envisaging the development of novel potential clinical treatments based on IL-8 blockade.
Efficacy and safety of platelet-rich plasma versus conventional care in diabetic foot ulcers: a meta-analysis of randomized controlled trials.
Xu H, Huang K, Tao X
Acta Diabetol · 2025 Oct · PMID 40600985 · Publisher ↗
PURPOSE: This meta-analysis aims to assess the efficacy and safety of platelet-rich plasma (PRP) through topical application and local injection methods compared to conventional care in patients with diabetic foot ulcers...
PURPOSE: This meta-analysis aims to assess the efficacy and safety of platelet-rich plasma (PRP) through topical application and local injection methods compared to conventional care in patients with diabetic foot ulcers (DFU). METHODS: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases up to November 2024. Randomized controlled trials evaluating the efficacy and safety of PRP versus conventional care in DFU patients were included. Pooled weighted mean differences (WMD) and risk ratios (RR) were calculated with 95% confidence intervals. RESULTS: Fifteen randomized controlled trials (1,010 patients) were included. The PRP group showed significantly improved complete healing rates compared to conventional care (RR: 1.53, 95% CI: 1.39-1.58, P < 0.001), with comparable effectiveness between topical application and local injection methods (P = 0.57). Notably, PRP demonstrated a shorter healing time compared to conventional care (WMD: -19.48 days, 95% CI: -27.91 to -11.05, P < 0.001). The PRP group exhibited lower wound infection rates and amputation rates (RR: 0.51, 95% CI: 0.35 to 0.75, P < 0.001; RR: 0.45, 95% CI: 0.26 to 0.79, P = 0.005). The PRP group did not lead to a higher incidence of treatment-related adverse events compared to conventional care (RR: 0.80, 95% CI: 0.05 to 12.30, P = 0.87). CONCLUSIONS: This meta-analysis confirms that PRP application, both topically and via local injection, improves the complete healing rate, reduces healing time, infection rates, and amputations, without increasing adverse events. These findings support the integration of PRP into clinical practice for the management of diabetic foot ulcers.
High glucose mediates diabetic peripheral neuropathy by inducing Schwann cells apoptosis through the Dgkh/PKC-α signaling pathway.
Zuo L, Qu M, Zhang M … +5 more , Cheng P, Guo M, Selvarajah D, Tesfaye S, Wu J
Acta Diabetol · 2025 Dec · PMID 40600984 · Publisher ↗
OBJECTIVE: Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes. The increased apoptosis of Schwann cells (SCs) induced by high glucose (HG) is significant in the pathogenesis...
OBJECTIVE: Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes. The increased apoptosis of Schwann cells (SCs) induced by high glucose (HG) is significant in the pathogenesis of DPN, but the mechanism remains unclear. Diacylglycerol kinase eta (Dgkh) is a member of the diacylglycerol kinases (DGKs) family that participates in glucose uptake, utilization, and energy homeostasis. But its role in DPN has not been reported. METHODS: Streptozotocin (STZ)-induced SD rats were used as an animal model of DPN and human Schwann cells (HSCs) were used as an in vitro model of simulated HG conditions. Behavioral tests, histopathology, the mRNA and protein expression levels were detected in vivo. Further, Dgkh was knocked down in vitro, and PKC-α agonist PMA and inhibitor Ro 31-8220 were added to HSCs to observe the effect of Dgkh/PKC-α on HSCs apoptosis. RESULTS: The mechanical and thermal pain thresholds were significantly decreased in DPN rats induced by STZ. The increased apoptosis of the sciatic nerve in STZ-induced DPN rats is accompanied by the upregulation of Dgkh expression. HG leads to increased HSCs apoptosis by Dgkh increased expression. Meanwhile, the knockdown of Dgkh significantly improved HSCs apoptosis induced by HG. PMA effectively improved apoptosis in HG-induced HSCs, but did not affect Dgkh expression. And we discovered that the apoptosis of HSCs reversed by Dgkh knockdown vanished when the PKC-α inhibitor Ro 31-8220 was added. CONCLUSION: Dgkh expression increased under HG conditions and triggered apoptosis of HSCs, boosting DPN via inhibiting PKC-α.
Unmasking heterogeneity in type 2 diabetes: the clinical relevance of phenotyping in the era of precision medicine.
Corrao S, Federici M
Acta Diabetol · 2025 Aug · PMID 40591035 · Publisher ↗
Despite its widespread use in clinical practice, the traditional dichotomous classification of diabetes into type 1 and type 2 fails to capture the marked heterogeneity observed in real-world patients, particularly those...
Despite its widespread use in clinical practice, the traditional dichotomous classification of diabetes into type 1 and type 2 fails to capture the marked heterogeneity observed in real-world patients, particularly those with type 2 diabetes mellitus (T2DM). The increasing recognition of the complex interplay between insulin resistance, beta-cell dysfunction, autoimmunity, and genetic predisposition has led to the development of phenotypic classification systems that aim to individualize care beyond glycemic targets. Ahlqvist et al. made a major contribution to this field by identifying five clinically meaningful clusters of adult-onset diabetes using routine clinical variables. These clusters differ in their metabolic profiles, complication risks, and therapeutic needs, offering a pragmatic starting point for personalized diabetology. Their clinical relevance has been further explored and validated by follow-up studies that include detailed metabolic phenotyping, cardiac imaging, and genetic analyses. Nevertheless, enthusiasm for cluster-based models must be tempered by critical appraisal. Evidence from large trials suggests that continuous clinical features may better predict disease progression and treatment response than static cluster assignments. Furthermore, these models have yet to be integrated into clinical guidelines or electronic decision-support systems. This Perspective argues for a multidimensional and dynamic approach to diabetes phenotyping, combining clinical, biochemical, imaging, and genetic data to reflect the evolving nature of the disease. Such a framework could enable more precise stratification and intervention, moving toward truly personalized diabetes care. Integrating these models into real-world settings represents the next frontier in precision diabetology.
New generation agents for glycemic control and diabetic retinopathy progression: what we need to know?
Vujosevic S, Toma C, Ferrulli A … +3 more , De Cillà S, Nucci P, Luzi L
Acta Diabetol · 2025 Oct · PMID 40586870 · Publisher ↗
AIMS: To report on the current evidence of early worsening of diabetic retinopathy (EWDR) in patients treated with new-generation antidiabetic agents, with a focus on glucagon-like peptide-1 receptor agonists (GLP1-RA)....
AIMS: To report on the current evidence of early worsening of diabetic retinopathy (EWDR) in patients treated with new-generation antidiabetic agents, with a focus on glucagon-like peptide-1 receptor agonists (GLP1-RA). METHODS: A comprehensive analysis of current literature was conducted, with a focus on studies evaluating the impact of glycemic control strategies and GLP1-RA on DR progression. References from landmark studies and recent trials were analyzed. RESULTS: Intensive glycemic control, while effective in reducing long-term microvascular complications including DR, has been associated with EWDR, particularly in cases with rapid HbA1c reductions. Emerging evidence links novel antidiabetic agents, including GLP1-RA, with increased risk of EWDR, though different studies have conflicting results. However, the risk of EWDR seems not to be directly linked to retinal toxicity from specific antidiabetic agents, but more likely to the rapid glycemic improvement. Risk factors for EWDR in these patients include higher baseline HbA1c, rapid and significant reductions in HbA1c levels during the first months of treatment, longer duration of diabetes, and more advanced stages of DR at baseline, while mild or moderate non-proliferative DR seem not be at higher risk of DR progression. CONCLUSIONS: While new antidiabetic therapies offer significant benefits for diabetes management, clinicians must be cautious when implementing intensive glycemic control in patients at risk for EWDR. Individualized treatment plans and close monitoring are essential to mitigate risks and optimize outcomes for patients with DR.
Associations between MASLD phenotypes and the risk of carotid artery plaque: a cross-sectional study among railway workers.
Pan J, Zeng H, Song Y … +7 more , Zhang X, Wang Z, Tang L, Xie B, Peng R, Zhou Y, Liu B
Acta Diabetol · 2025 Dec · PMID 40553390 · Publisher ↗
AIMS: Current evidence on the association between metabolic dysfunction-associated steatotic liver disease (MASLD) phenotypes to carotid artery plaque (CAP) remains limited. This study aims to investigate both the associ...
AIMS: Current evidence on the association between metabolic dysfunction-associated steatotic liver disease (MASLD) phenotypes to carotid artery plaque (CAP) remains limited. This study aims to investigate both the association and the potential mediating effects of MASLD phenotypes on the risk of CAP. METHODS: In this cross-sectional study, 8644 participants were categorized into five groups based on hepatic steatosis and cardiometabolic criteria: Non-hepatic steatosis, Dysglycemia-MASLD, Overweight-MASLD, Lean-MASLD, and other hepatic steatosis. Multivariable logistic regression analysis was conducted to evaluate the association between MASLD phenotypes and CAP. Mediation analyses were performed to evaluate the mediating effect of dysglycemia and body mass index (BMI) on the relationship between MASLD and CAP. RESULTS: The Dysglycemia-MASLD group exhibited the highest prevalence of CAP of 26.28%, followed by the Lean-MASLD (18.55%) and Overweight-MASLD (14.39%) groups. After adjusting for covariates, Dysglycemia-MASLD patients had a significantly higher risk of CAP, with an OR of 1.599 (95% CI 1.348, 1.896). Notably, individuals under 45 in the Dysglycemia-MASLD and Lean-MASLD subgroups had more than a two-fold increased risk of CAP compared to the Non-hepatic steatosis group, with ORs of 2.393 (95% CI 1.660, 3.416) and 2.724 (95% CI 1.002, 6.221), respectively. Mediation analysis indicated that dysglycemia and BMI mediated 30.86% and 24.49% of the association of MASLD with CAP. CONCLUSION: The risk of developing CAP varies across MASLD phenotypes, with Dysglycemia-MASLD and Lean-MASLD patients exhibiting the highest risk. Therefore, personalized health management strategies are essential for different MASLD phenotypes.
Effects of a health education intervention based on the behavior change wheel on fear of hypoglycemia behavior in type 2 diabetes mellitus patients: a randomized controlled pilot trial.
Zhao Y, Zhang L, Pang J … +8 more , Qiu J, He Y, Xu Z, Han M, Liu L, Wan X, Wang J, Zhang Y
Acta Diabetol · 2025 Dec · PMID 40548996 · Publisher ↗
AIMS: To conduct a pilot randomized trial of an intervention based on the behavior change wheel (BCW) to reduce fear of hypoglycemia (FoH) behavior in person with Type 2 diabetes mellitus. Additionally, the study assesse...
AIMS: To conduct a pilot randomized trial of an intervention based on the behavior change wheel (BCW) to reduce fear of hypoglycemia (FoH) behavior in person with Type 2 diabetes mellitus. Additionally, the study assessed the program's feasibility, acceptability, and preliminary effects. METHODS: This study utilized a single-blind, parallel randomized controlled trial design. The intervention included in-person education during hospitalization, online coaching post-discharge and follow-up. Effectiveness was assessed by comparing changes in primary outcomes (FoH behavior and worry), secondary outcomes (impaired hypoglycemia awareness, medical support, and self-management attitudes). RESULTS: Recruitment (82%) and completion rate (100%) indicated feasibility. Qualitative interviews and satisfaction surveys indicated acceptability. The intervention group significantly reduced FoH (behavior and worry) scores compared to the controls (F = 49.060-98.057, P < 0.001, η = 0.632-0.774). Also, lower impaired hypoglycemia awareness (F = 4.036, P = 0.024, η = 0.082) and improved medical support (F = 58.925, P < 0.001, η = 0.664), self-management attitudes (F = 7.931, P = 0.001, η = 0.143) were observed. CONCLUSION: The BCW-based intervention is feasible, acceptable, and improves not only FoH behavior and worry, but also impaired awareness of hypoglycemia, medical support, and self-management attitudes. TRIAL REGISTRATION: The study was retrospective registered on ClinicalTrials.gov (identifier: NCT06197360), registration date: 05/1/2024.
Should we treat mild gestational diabetes? An Australian multicentre retrospective cohort study.
Rudland VL, Hibbert E, Flack J … +6 more , Wong T, Wong VW, McLean M, Pasupathy D, Simmons D, Cheung NW
Acta Diabetol · 2025 Dec · PMID 40540215 · Full text
AIMS: The International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria for gestational diabetes (GDM) were widely implemented in Australia, despite limited evidence of better pregnancy out...
AIMS: The International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria for gestational diabetes (GDM) were widely implemented in Australia, despite limited evidence of better pregnancy outcomes compared to the Australasian Diabetes in Pregnancy Society 1998 (ADIPS1998) criteria. We aimed to evaluate the effect of treatment on pregnancy outcomes for women with 'mild' GDM, defined as GDM diagnosed by one, but not both, sets of criteria. METHODS: This multicentre, retrospective cohort study included 17,512 pregnant women in six neighbouring tertiary hospitals in Sydney, Australia, during 2016-2017, all of whom were screened for GDM using a three-point 75 g oral glucose tolerance test. Three hospitals diagnosed and treated GDM according to ADIPS1998 criteria, and three according to IADPSG criteria. For women with 'mild' GDM, we evaluated the effect of treatment versus no treatment on pregnancy outcomes. The primary outcome was large for gestational age. Secondary outcomes were small for gestational age, induction of labour, caesarean section, gestational hypertension, and preeclampsia. RESULTS: 2320 (13.2%) pregnant women had 'mild' GDM. Treatment of women with IADPSG-only GDM (i.e. fasting glucose 5.1-5.4 mmol/L (91-97 mg/dL) and/or 1-hour glucose ≥ 10.0 mmol/L (≥ 180 mg/dL)) was associated with less large for gestational age infants than no treatment (RR 0.66, 95%CI 0.49-0.88, p = 0.004) but more induction of labour (RR 1.55, 95%CI 1.03-2.34, p = 0.032). Treatment of women with ADIPS1998-only GDM (i.e. 2-hour glucose 8.0-8.4 mmol/L (144-151 mg/dL)) did not significantly change pregnancy outcomes compared with no treatment. CONCLUSIONS: This study highlights the importance of treating even mild IADPSG-GDM to improve pregnancy outcomes.
Mitochondrial DNA variations and risk of incident gestational diabetes mellitus: a nested case-control study.
Liu Y, Li X, Zhao M … +6 more , Zhao Y, Zhou Y, Yu H, Zhao K, Zhao S, Shang X
Acta Diabetol · 2025 Dec · PMID 40540214 · Publisher ↗
AIMS: Gestational diabetes mellitus (GDM) is associated with mitochondrial dysfunction. Mitochondrial DNA (mtDNA) plays a critical role in mitochondrial function, affecting cellular oxidative phosphorylation and ATP supp...
AIMS: Gestational diabetes mellitus (GDM) is associated with mitochondrial dysfunction. Mitochondrial DNA (mtDNA) plays a critical role in mitochondrial function, affecting cellular oxidative phosphorylation and ATP supply. This study aims to explore the association between mtDNA variations and GDM in Han Chinese women. METHODS: This nested case-control study was conducted among 701 women who developed GDM and 859 contemporaneous controls based on the Chinese Birth Cohort of Environmental and Genetic Factors between 2018 and 2022. Next-generation sequencing was performed on the samples to detect variations in the whole mitochondrial genome. The sequencing data were analyzed, and the differences in the number of mtDNA variations between the two groups were assessed using a t-test. Haplogroup analysis was conducted through the chi-square test. Logistic regression analysis was performed, adjusting for age, BMI, gravidity, and parity, to identify significantly different mtDNA variations between the two groups. RESULTS: Pregnant women with GDM carried fewer mtDNA variants in the D-loop region (11.35 ± 2.77 vs. 11.80 ± 2.86, p = 0.002). Results indicated that m.73A>G (OR: 0.46, 95% CI: 0.28-0.77, p = 0.003), m.185G>A (OR: 0.41, 95% CI: 0.18-0.92, p = 0.030), m.16051A>G (OR: 0.24, 95% CI: 0.07-0.84, p = 0.026), m.16092T>A (OR: 9.21, 95% CI: 1.11-76.42, p = 0.040) and m.16291C>T (OR: 2.35, 95% CI: 1.29-4.28, p = 0.005) in the D-loop region and m.6228C>T (OR: 9.41, 95% CI: 1.14-77.59, p = 0.037) in MT-CO1 gene were found to be significantly different between GDM cases and the controls. CONCLUSIONS: This study revealed an association between mtDNA variations and GDM, highlighting the potential that screening for specific mtDNA variants in early pregnancy may predict the development of GDM.
Maternal liver fibrosis indices as predictors of adverse perinatal outcomes in patients with gestational diabetes mellitus.
Gezer M, Taşdemir Ü, Eyisoy ÖG … +3 more , Yiğit S, Özdemir ME, Demirci O
Acta Diabetol · 2025 Dec · PMID 40540213 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the FIB-4 and APRI scores in patients with gestational diabetes mellitus (GDM) and investigate their associations with neonatal outcomes. Additionally, the predictive value of thes...
OBJECTIVE: This study aimed to evaluate the FIB-4 and APRI scores in patients with gestational diabetes mellitus (GDM) and investigate their associations with neonatal outcomes. Additionally, the predictive value of these non-invasive fibrosis indices for GDM and adverse perinatal outcomes was assessed. MATERIALS AND METHODS: In this retrospective case-control study, 200 pregnant women diagnosed with GDM and 200 healthy controls were analyzed. Data on maternal demographics, laboratory parameters (ALT, AST, platelet count), FIB-4 and APRI scores, perinatal and neonatal outcomes including fetal growth restriction (FGR), oligohydramnios, polyhydramnios, birth weight, gestational age at birth, neonatal cord blood pH, neonatal hypoglycemia, Apgar 1 min. and 5 min. scores, and neonatal intensive care unit (NICU) admission were collected. Logistic regression analyses were performed to identify independent predictors of adverse perinatal outcomes among GDM patients. ROC analysis was used to determine the diagnostic performance of both indices. RESULTS: FIB-4 and APRI scores were significantly higher in GDM patients compared to controls (p < 0.05). Among GDM patients, those with FGR, NICU admission, or neonatal death had significantly elevated FIB-4 scores. Stratification by FIB-4 risk categories revealed that patients with high FIB-4 scores had increased rates of FGR, fetal hypoglycemia, adverse perinatal outcomes, and NICU admission (p < 0.01). ROC analysis for predicting GDM yielded AUC values of 0.577 for FIB-4 and 0.571 for APRI. For predicting adverse perinatal outcomes, the FIB-4 AUC was 0.590, while APRI showed limited predictive ability (AUC = 0.511). CONCLUSION: FIB-4 can serve as a valuable non-invasive marker for liver dysfunction in GDM and is significantly associated with adverse perinatal outcomes. Despite limited predictive power, these scores may serve as early indicators of hepatic involvement in GDM.
Polygenic score from MODY genes is associated with type 1 diabetes and disease characteristics.
Catamo E, Conti A, Franceschi R … +14 more , Dovc K, Morosini C, Tinti D, Aldegheri L, Cappellani S, Tamaro G, Zanfardino A, Faleschini E, Rabbone I, Bonfanti R, Battelino T, Iafusco D, Tornese G, Robino A
Acta Diabetol · 2025 Nov · PMID 40540212 · Full text
AIMS: This study evaluates the contribution of common variants in Maturity-Onset Diabetes of the Young (MODY) genes on type 1 diabetes (T1D), using a polygenic score (PGS) approach. METHODS: 485 children and youth diagno...
AIMS: This study evaluates the contribution of common variants in Maturity-Onset Diabetes of the Young (MODY) genes on type 1 diabetes (T1D), using a polygenic score (PGS) approach. METHODS: 485 children and youth diagnosed with T1D from at least 1 year and 271 healthy controls (HC) were recruited. Personal information (i.e. age, sex, height, weight) were collected for each participant, and clinical information (i.e. age at diagnosis, disease duration, presence of autoantibodies and ketoacidosis at onset (DKA)) were also obtained for T1D subjects. Participants were genotyped using Illumina Infinium Global Screening Array. PGS based on Single Nucleotide Polymorphisms (SNPs) in 16 MODY genes were developed. The association of this PGS with T1D susceptibility and clinical disease characteristics was assessed by regression analysis. RESULTS: A PGS including 335 SNPs in MODY genes discriminates T1D from HC (AUC = 60.1%, AIC = 787.6). This PGS was significantly higher in T1D compared to HC (p-value = 0.0004, pseudo-R2 = 2.85%). Moreover, regression analysis between PGS and T1D clinical characteristics showed higher PGS values in T1D subjects with zinc transporter 8 autoantibodies (ZnT8A) compared with T1D subjects without ZnT8A (p-value = 0.04). A similar trend was also observed for antibodies directed against glutamic acid decarboxylase (GADA), although the association did not reach statistical significance (p-value = 0.06). CONCLUSIONS: Our study suggests that a polygenic approach based on MODY genes may discriminate T1D from HC and may contribute to patient stratification, helping to better understand T1D heterogeneity.
The association of peripheral blood METTL3 mRNA expression levels with prediabetes and type 2 diabetes mellitus: the Henan rural cohort study.
Jiang Y, Ren X, Li Y … +5 more , Chang G, Pan X, Zhang Y, Wang C, Liu X
Acta Diabetol · 2025 Nov · PMID 40540211 · Publisher ↗
AIM: We aimed to investigate the association of peripheral blood METTL3 (Methyltransferase Like 3) mRNA expression levels with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A...
AIM: We aimed to investigate the association of peripheral blood METTL3 (Methyltransferase Like 3) mRNA expression levels with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A case-control study including 1501 participants from the Henan Rural Cohort study was performed. Peripheral blood METTL3 mRNA expression levels were quantified by qRT-PCR. Binary logistic regression was used to generate odds ratio (OR) and 95% confidence intervals (CI) for the risk of IFG and T2DM. Restricted cubic spline was used to generate the dose-response relationship between METTL3 mRNA expression levels and IFG and T2DM. RESULTS: METTL3 mRNA expression levels were downregulated in T2DM compared with normal glucose tolerance (NGT) (4.03 ± 1.09 vs. 3.96 ± 0.93). After adjusting covariates, the risk of developing IFG in METTL3 mRNA high expression levels group was 30% higher than that in the low expression levels group (OR = 1.30,95%CI:1.02,1.65). Conversely, METTL3 mRNA expression levels were negatively correlated with T2DM(OR = 0.83,95%CI:0.72,0.96) compared to the NGT group. METTL3 mRNA expression levels showed a non-linear correlation with both IFG and T2DM. CONCLUSION: METTL3 mRNA expression levels exhibited opposing effects on IFG and T2DM. Elevated METTL3 mRNA levels were positively associated with IFG risk but inversely associated with T2DM risk.
Needle characteristics and the insulin injection experience in patients with diabetes.
Mannucci E, Pintaudi B, Lunati ME … +1 more , Fiorina P
Acta Diabetol · 2025 Sep · PMID 40481976 · Publisher ↗
BACKGROUND: Fear of pain during insulin injection, using pen injectors, still represents a barrier to diabetes treatment. The development of smaller and thinner needles has improved comfort during the injection, but the...
BACKGROUND: Fear of pain during insulin injection, using pen injectors, still represents a barrier to diabetes treatment. The development of smaller and thinner needles has improved comfort during the injection, but the influence of other needle geometry features, has been less thoroughly assessed. The aim of this review, is to evaluate the role that pen needle geometry plays in determining patient experience during insulin injection. METHODS: A literature search was conducted in PubMed and Scopus to identify the publications assessing the effect of needle geometry and quality on insertion force and pain, experienced by the patient during injection. 22 studies were included in this review. All studies included, at minimum, an evaluation of the perceived injection pain, using a Visual Analogue Scale (VAS). RESULTS: The clinical evidence demonstrated that in addition to the pain reduction experienced with increasing needle gauge, other geometrical features such as shorter needle length, thinner wall design, improved tip geometry and coating with lubricant, are associated with reduced injection pain and improved patient experience. Furthermore, it was indicated that the needle features shown to help reduce the experienced pain, would not negatively affect the frequency and intensity of injection related site reactions or needle-related failures, such as breakage and bending. CONCLUSIONS: Pen needle geometry affects the insulin injection experience of diabetic patients. Increased needle gauge, shorter length, improved tip design and mechanical characteristics of the needle are all associated with a perceived reduction of the pain during insulin injection and an overall improved patient experience.
Continuous interstitial glucose monitoring in diabetic and non-diabetic critically ill patients is simple and accurate: comparison with venous, arterial and capillary glucose measurements.
Chiumello D, Passeri M, Coppola S … +9 more , Chiodaroli E, Carnier S, Montante M, Pozzi T, Goggi I, Bifari F, Mortola U, Centofanti L, Folli F
Acta Diabetol · 2025 Aug · PMID 40481975 · Full text
INTRODUCTION: To reduce mortality, thigh glycemic control is recommended in critically ill patients due to their extreme glycemic variability. Continuous glucose monitoring (CGM) devices allows frequent determination of...
INTRODUCTION: To reduce mortality, thigh glycemic control is recommended in critically ill patients due to their extreme glycemic variability. Continuous glucose monitoring (CGM) devices allows frequent determination of blood glucose levels; however, conflicting results have been reported from studies assessing their accuracy in critically ill patients. Aim of this study was to assess the repeatability and the analytical and clinical accuracy of FreeStyle Libre 2 (FSL-)CGM. MATERIALS AND METHODS: Prospective single-center observational study enrolling 40 critically ill patients. For four consecutive days, we measured three consecutive interstitial FSL-CGM-derived glucose levels, along with one arterial and venous blood gas analysis and a capillary-derived blood glucose level, obtaining a total of 480 FSL-CGM-derived glucose measurements and 160 measurements from arterial and venous blood gas analysis and from capillary glucose. RESULTS: The mean blood glucose levels in the three daily timepoints from FSL-CGM were 130 ± 35, 131 ± 35 and 131 ± 35 mg/dL (p = 0.660). The Bland-Altman analysis comparing arterial BGA- and FSL-CGM-derived blood glucose levels had a bias of 10.3 mg/dL with limits of agreement from - 27.2 to 47.7. The mean absolute relative difference (MARD) between FSL-CGM and arterial blood gas analysis was 12 ± 10%. The Clarke, Parkes and Surveillance error grid analyses comparing arterial BGA- and FSL-CGM-derived blood glucose levels showed a good clinical accuracy. The presence of diabetes did not influence analytical accuracy, while the use of vasopressors was associated with a higher MARD. CONCLUSIONS: FSL-CGM demonstrated reproducibility and reliable analytical and clinical accuracy in critically ill patients, without difference between diabetic and non-diabetic patients, over a period of up to 96 h (4 days).
Obesity paradox: association between lipid metabolism indices and skeletal muscle mass in older adults: the mediating role of uric acid.
Sun C, Yang X, Feng X
Acta Diabetol · 2025 Nov · PMID 40471301 · Publisher ↗
AIMS: This study aimed to explore the relationships between lipid metabolism indices-the Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), Cardiac Metabolic Index (CMI), and Atherogenic Index of Plasma (A...
AIMS: This study aimed to explore the relationships between lipid metabolism indices-the Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), Cardiac Metabolic Index (CMI), and Atherogenic Index of Plasma (AIP)-and sarcopenia in individuals aged ≥ 60 years, and to investigate the mediating role of uric acid (UA) in these relationships. The goal was to provide scientific evidence and practical guidance for preventing and treating sarcopenia in older adults. METHODS: Data from 2001 participants aged ≥ 60 years in the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were analyzed. Statistical analyses, including logistic regression, restricted cubic splines (RCS), subgroup analysis, and mediation analysis, were conducted to examine the associations among various lipid metabolism indices, UA levels, and sarcopenia. RESULTS: Multivariable-adjusted models revealed significant inverse associations between lipid metabolism indices and sarcopenia (all P < 0.05). In the fully adjusted model (model III), the adjusted odds ratios (OR) for LAP, VAI, CMI, and AIP were 0.97 (95% CI: 0.97-0.98), 0.78 (0.68-0.89), 0.32 (0.21-0.49), and 0.27 (0.15-0.52), respectively (all P < 0.05). RCS analyses revealed inverse dose-response relationships between lipid metabolism indices and sarcopenia. The ROC analysis revealed that LAP showed the highest diagnostic value among the four indices. Subgroup analyses showed no significant differences in this relationship across different subgroups. Notably, UA partially mediated these associations (mediation proportions: 8.91-20.66%). These findings suggest that maintaining lipid homeostasis and UA levels may offer protective benefits against age-related sarcopenia. CONCLUSIONS: Our findings advance the understanding of the obesity paradox by revealing that higher lipid metabolism indices (LAP, VAI, CMI, AIP) and UA levels are inversely associated with sarcopenia in the elderly, with UA partially mediating these protective effects. These results highlight the importance of maintaining lipid and UA levels within normal ranges as a potential novel strategy for preventing and managing sarcopenia. These findings suggest that reconsidering these biomarkers in the management of geriatric muscle health is necessary, highlighting their importance in understanding and addressing the pathogenesis of sarcopenia in aging populations.
Use of the temporary glycemic target feature in the medtronic MiniMed™ 780G advanced hybrid closed loop system: a real-world evidence study.
Basset-Sagarminaga J, van den Heuvel T, Castañeda J … +1 more , Cohen O
Acta Diabetol · 2025 Nov · PMID 40471300 · Publisher ↗
AIM: The MiniMed™ 780G system utilizes an Advanced Hybrid Closed-Loop algorithm, which is optimized to perform best at a glucose target of 100 mg/dL. The system also includes a temporary target feature (TT) of 150 mg/dL...
AIM: The MiniMed™ 780G system utilizes an Advanced Hybrid Closed-Loop algorithm, which is optimized to perform best at a glucose target of 100 mg/dL. The system also includes a temporary target feature (TT) of 150 mg/dL that can be set when higher glucose utilization is anticipated (e.g., exercise/strenuous work). METHODS: Real-world data from 1002 randomly selected users of the MiniMed™ 780G and MiniMed™ 670G systems were used to investigate the TT functionality (n = 501 MiniMed™ 780G users, n = 501 MiniMed™ 670G users). Continuous glucose monitoring (CGM) metrics were calculated for 4-h intervals (4 h prior to commencing TT use and 0-4, 4-8, 8-12, 12-16, 16-20 and 20-24 h after TT initiation). RESULTS: CGM results showed that, with both systems, the time-in-range (TIR) during TT periods mostly equalled or exceeded TIR in corresponding non-TT periods. In the first 4 h after TT initiation, the MiniMed™ 780G system demonstrated a TIR and time in tight range (TITR) of 71.6% and 46.4%, respectively, [a 1.6 (p = 0.11) and 2.6 (p = 0.009) percentage point benefit in TIR and TITR, respectively, versus the 670G system]. Mean time-below-range remained below target in both periods. CONCLUSIONS: These findings confirm that the TT setting performs as intended, allowing users to maintain TIR during strenuous activity without compromising safety.
NF-κB p65 mediated lnc-Traf3ip2 exacerbates renal fibrosis in diabetic kidney disease.
Wu K, Li P, Zha H … +8 more , Wu T, Liu H, Peng R, Lv D, Lin Z, Liao X, Sun Y, Zhang Z
Acta Diabetol · 2025 Nov · PMID 40471299 · Publisher ↗
AIMS: Diabetic kidney disease (DKD) is the predominant type of end-stage renal disease. The fibrotic response in glomerular mesangial cells (MCs) acts as an initial injury during DKD progression, but the molecular mechan...
AIMS: Diabetic kidney disease (DKD) is the predominant type of end-stage renal disease. The fibrotic response in glomerular mesangial cells (MCs) acts as an initial injury during DKD progression, but the molecular mechanism remains to be explored. Here, this present study aimed to investigate the role of NF-κB p65 mediated long noncoding RNA (lncRNA) lnc-Traf3ip2 in renal fibrosis and DKD progression. METHODS: The different expressions of lncRNAs in renal tissues of db/db DKD mice (n = 3) and db/dm controls (n = 3) were screened by scRNA-seq and RNA-seq. Plasma of DKD patients (n = 40) and renal tissues of DKD mice (n = 35) and their controls were further used to examine the expressions of lnc-Traf3ip2. Moreover, the relationship between the expression of lnc-Traf3ip2 and indexes of kidney function was also analyzed by Pearson correlation coefficient analysis. Furthermore, the biological functions of lnc-Traf3ip2 in mesangial cell fibrosis and renal injury were investigated by qRT-PCR, western blot and immunofluorescence in DKD in vivo and in vitro. Finally, the dual-luciferase reporter assay and ChIP were performed to investigate the regulatory mechanism of lnc-Traf3ip2 transcription. RESULTS: In our study, the results of scRNA-seq, RNA-seq and qRT-PCR revealed that lnc-Traf3ip2, which was highly expressed in mesangial cells and upregulated in renal tissues of DKD mice and the plasma of DKD patients. Data also showed lnc-Traf3ip2 was positively correlated with UACR in DKD. Moreover, overexpression of lnc-Traf3ip2 could promote fibrosis of MCs in vitro, whereas silencing lnc-Traf3ip2 alleviated MCs fibrosis under high glucose condition. Additionally, lnc-Traf3ip2 knockdown alleviated renal fibrosis in DKD mice. Mechanistically, transcription factor NF-κB subunit p65 could promote the expression of lnc-Traf3ip2 via directly binding to the promoter of lnc-Traf3ip2. CONCLUSIONS: Taken together, our data suggest the role of lnc-Traf3ip2 in fibrogenic factor in DKD induced by transcription factor NF-κB p65 and identified it as an therapeutic target for DKD.
Polypharmacy in older patients with diabetes mellitus: a population based-study of northern Italy.
Succurro E, Ojeda-Fernández L, Franchi C … +6 more , Zanovello A, Pierini L, Nobili A, Fortino I, Sesti G, Baviera M
Acta Diabetol · 2025 Nov · PMID 40471298 · Full text
AIMS: To evaluate the trends in chronic polypharmacy and identify predictors of polypharmacy exposure in a population residing in Lombardy region of Italy. METHODS: Using an administrative health database, we identified...
AIMS: To evaluate the trends in chronic polypharmacy and identify predictors of polypharmacy exposure in a population residing in Lombardy region of Italy. METHODS: Using an administrative health database, we identified individuals aged 65-90 years with diabetes mellitus (DM) treated with antihyperglycemic drugs from 2010 to 2022. The trend of chronic polypharmacy was assessed using the Cochran-Armitage trend test. An adjusted logistic regression model was employed to analyze predictors of polypharmacy exposure. RESULTS: The number of older patients with DM increased from 243,160 in 2010 to 314,238 in 2022. The prevalence of polypharmacy exposure rose from 13.8% in 2010 to 15.8% in 2013, followed by a decline starting in 2014. Notably, in 2020, the prevalence dropped to 11.8%, further decreasing to 9.1% in 2021, before rising again to 11.7% in 2022. We also observed an increased use of recommended antihyperglycemic drugs over time. Significant predictors of polypharmacy exposure included advanced age, female sex, comorbidities, and use of DPP-4i, GLP-1-RA, insulin, and SGLT2-i. CONCLUSIONS: The observed decrease in polypharmacy in the latter years of the study period may reflect improvements in the management of older patients with DM, aligning with recommended therapies, particularly for those at higher risk of polypharmacy.
Association of GLP-1 receptor agonists with risk of intestinal obstruction in patients with type 2 diabetes mellitus: a retrospective cohort study.
Gao Z, Tabernacki T, Dorney I … +3 more , Ding P, Kaelber DC, Xu R
Acta Diabetol · 2025 Nov · PMID 40471297 · Full text
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for treating type 2 diabetes and weight loss. There have been concerns that GLP-1RAs may increase the risk of intestinal obstruction. OBJECTIV...
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for treating type 2 diabetes and weight loss. There have been concerns that GLP-1RAs may increase the risk of intestinal obstruction. OBJECTIVE: Investigate the association between GLP-1RAs use and intestinal obstruction in a large cohort of patients with type 2 diabetes mellitus (T2DM) in the U.S. DESIGN: A retrospective cohort study was conducted using longitudinal electronic health records sourced from TriNetX, a large-scale, population-based health database. PARTICIPANTS: The study included over 1.2 million T2DM patients who were prescribed anti-diabetic medications, including 181,795 prescribed GLP-1RAs between April 2013 and April 2019. MAIN MEASURES: The incidence of intestinal obstruction was compared between GLP-1RAs and each of six other classes of non-GLP-1RA anti-diabetic medications. Hazard ratios (HRs) at 1, 3, and 5-year follow-up periods were calculated using Cox proportional hazards analysis. Separate analyses were performed in T2DM patients with and without obesity. KEY RESULTS: The risk of intestinal obstruction did not differ between GLP-1RAs and other anti-diabetic medications except for a reduced risk compared with insulins. The results were consistent for 1, 3, and 5-year follow-up periods and in patients with and without obesity. CONCLUSIONS: Our findings do not support an increased risk of intestinal obstruction in T2DM patients prescribed GLP-1 RAs compared to other anti-diabetic medications.
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