Journal Description
Diabetology
Diabetology
is an international, peer-reviewed, open access journal on diabetes research published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), Scopus, EBSCO, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 26 days after submission; acceptance to publication is undertaken in 4.8 days (median values for papers published in this journal in the first half of 2024).
- Journal Rank: CiteScore - Q2 (Medicine (miscellaneous))
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Impact Factor:
2.4 (2023);
5-Year Impact Factor:
2.4 (2023)
Latest Articles
Uses of African Plants and Associated Indigenous Knowledge for the Management of Diabetes Mellitus
Diabetology 2024, 5(5), 476-490; https://doi.org/10.3390/diabetology5050035 - 27 Sep 2024
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Diabetes mellitus (DM) is a common non-communicable and chronic metabolic disorder regarded as a global epidemic with high morbidity and mortality. Although, conventional medicines are available for the management of DM, Indigenous knowledge, including the use of botanicals, has contributed to the management
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Diabetes mellitus (DM) is a common non-communicable and chronic metabolic disorder regarded as a global epidemic with high morbidity and mortality. Although, conventional medicines are available for the management of DM, Indigenous knowledge, including the use of botanicals, has contributed to the management of this life-threatening disease in Africa. This is due to the perceived effectiveness and minimal side effects associated with plants and plant-derived compounds as an affordable remedy against DM. This review focuses on the contribution of Indigenous African plants to the management of DM. Relevant literatures were reviewed from online scientific databases, such as PubMed, ScienceDirect, and Google Scholar, using keywords singly and in combination. The review revealed that Indigenous health practitioners use several medicinal plants in the management of DM, with a range of 14–255 botanicals recorded. Approximately 80 compounds with antidiabetic potency have been isolated from different parts of African medicinal plants, with the majority belonging to flavonoids and terpenoids. Particularly, compounds such as apigenin, combretin B, convallatoxin, kaempferol, and quercetin remain the most promising antidiabetic compounds isolated from African medicinal plants. Limited clinical trials have been conducted on these compounds despite these milestones. There is, therefore, the need for further investigations to explain their antidiabetic effects, particularly under clinical conditions. Plants from which these compounds were isolated were selected based on ethnopharmacological knowledge. With these developments, medicinal plants and Indigenous knowledge remain an integral part of the global strategy to combat DM.
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Open AccessArticle
A Pilot Study on the Fecal Microbiota in Mexican Women with Gestational Diabetes Mellitus and Their Newborns
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Dennise Lizárraga, Alejandra García-Gasca, Teresa García-Gasca, Gertrud Lund, Abraham Guerrero, Efrén Peraza-Manjarrez and Bruno Gómez-Gil
Diabetology 2024, 5(5), 464-475; https://doi.org/10.3390/diabetology5050034 - 25 Sep 2024
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Introduction: The gut microbiota plays important roles in physiological and immune processes. Some metabolic disorders and complications during pregnancy, such as gestational diabetes mellitus (GDM), have been associated with alterations in the gut microbiota. The aim of this study was to characterize alterations
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Introduction: The gut microbiota plays important roles in physiological and immune processes. Some metabolic disorders and complications during pregnancy, such as gestational diabetes mellitus (GDM), have been associated with alterations in the gut microbiota. The aim of this study was to characterize alterations in fecal microbiota (as a non-invasive proxy of the gut microbiota) by 16S rRNA (V3-V4) taxonomic fingerprinting in Mexican women with GDM and their newborns. Methods: A total of 17 pregnant women (GDM = 8 and control = 9) were recruited between April 2021 and August 2022, and fecal samples were collected in the third trimester of gestation and during cesarean section. A total of 16 newborns (GDM = 8 and control = 8) participated in the study; meconium samples were taken immediately after birth. Results: The maternal microbiota (both at the third trimester and cesarean section) exhibited higher alpha diversity and a different bacterial community structure compared to that of their newborns. The maternal fecal microbiota of the third trimester from the GDM group showed a significant increase in the abundance of Firmicutes, Lachnospiraceae, Ruminococcaceae, Blautia, Rosebura, and Faecalibacterium, and a significant decrease in Peptostreptococcaceae, Anaerococcus, and Finegoldia, compared to the control group; these taxa correlated with blood glucose levels (except for Ruminococcaceae) but not with body mass index (BMI). No significant differences were observed between GDM and control groups in the relative abundance of maternal fecal microbiota collected in the cesarean section. The meconium microbiota of newborns from mothers with GDM showed a significant increase in Faecalibacterium compared with newborns from normoglycemic mothers and correlated with the mothers’ BMI and fasting glucose levels. Conclusions: The results indicate that GDM is associated with alterations in the fecal microbiota of women with GDM in the third trimester, in particular, with taxa known to be associated with metabolic disorders and other types of diabetes, and modifications in the meconium microbiota of their newborns.
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Open AccessArticle
A Randomized Crossover Study Comparing the Effects of Diabetes-Specific Formula with Common Asian Breakfasts on Glycemic Control and Satiety in Adults with Type 2 Diabetes Mellitus
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Sing Teang Kong, Dieu Thi Thu Huynh, Weerachai Srivanichakorn, Weerapan Khovidhunkit, Chaiwat Washirasaksiri, Tullaya Sitasuwan, Chengrong Huang, Swapnil Paunikar, Menaka Yalawar and Siew Ling Tey
Diabetology 2024, 5(4), 447-463; https://doi.org/10.3390/diabetology5040033 - 19 Sep 2024
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Postprandial hyperglycemia was shown to be an independent risk factor for microvascular and macrovascular complications in type 2 diabetes mellitus (T2D). We aimed to investigate the glucose, insulin, and subjective appetite at 0, 15, 30, 45, 60, 90, 120, 150, and 180 min
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Postprandial hyperglycemia was shown to be an independent risk factor for microvascular and macrovascular complications in type 2 diabetes mellitus (T2D). We aimed to investigate the glucose, insulin, and subjective appetite at 0, 15, 30, 45, 60, 90, 120, 150, and 180 min of three treatments: diabetes-specific formula (DSF), noodle soup, and glutinous rice. This was a randomized, crossover study with a one-week interval between treatments. Sixty-four T2D adults with oral glucose-lowering medication and HbA1c between 7% and <10% were randomized. The glucose positive area under the curve from 0 to 180 min (pAUC) was significantly lower with DSF than with glutinous rice (LSM ± SE: DSF 354 ± 32 vs. glutinous rice 451 ± 32 mmol.min/L, p = 0.033). The insulin pAUC was significantly lower with DSF (median [IQR]: 2733 [1542, 4204]) compared to glutinous rice (3359 [2193, 4744] µIU.min/mL), p = 0.042). The insulinogenic index at 30 min was significantly higher in DSF (median [IQR], 8.1 [4.2, 19.7]) compared to glutinous rice (5.4 [2.7, 11.7], p < 0.001). No significant differences were found in subjective appetite between the three treatments (all, p ≥ 0.827). There were also no significant differences in hunger, fullness, desire to eat, and prospective consumption ratings between DSF and the other two breakfasts (all p ≥ 0.181). Noodle soup led to the shortest time for hunger to return to baseline (165 min), 21 min earlier than DSF (186 min) and 32 min earlier than glutinous rice (197 min). DSF significantly reduced postprandial glucose and insulin responses compared with glutinous rice and had a higher satiating value than noodle soup in T2D adults. Replacing common Asian breakfasts with DSF may improve glycemia and hunger control.
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Open AccessReview
The Prevalence of Gestational Diabetes Mellitus in Polycystic Ovary Disease—A Systematic Review, Meta-Analysis, and Exploration of Associated Risk Factors
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Rajani Dube, Taniqsha Bambani, Sahina Saif, Noha Hashmi, Mohamed Anas Mohamed Faruk Patni and Noopur Ramesh Kedia
Diabetology 2024, 5(4), 430-446; https://doi.org/10.3390/diabetology5040032 - 4 Sep 2024
Abstract
Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications, including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence
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Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications, including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials and Methods: A systematic search of the electronic database was done using keywords like PCOS and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. After assessing the risk of bias, studies with a high risk (of bias) were excluded, and a meta-analysis was conducted using relative risks and confidence intervals. Results and Discussion: Out of 1896 search results, 95 were selected for full-text review. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55% (2.9–54.9%) from pooled data involving 1,280,245 women. The prevalence of PCOS in women diagnosed with GDM, based on pooled data from 36,351 women across retrospective studies, was found to be 2.47% (ranging from 1.5% to 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis found that the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p < 0.001). Family history of diabetes, ethnicity, high pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were found to be associated with GDM in women with PCOS. Conclusion: The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters with different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.
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(This article belongs to the Special Issue Women’s Special Issue Series: Diabetology)
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Open AccessReview
Metabolic Syndrome Drug Therapy: The Potential Interplay of Pharmacogenetics and Pharmacokinetic Interactions in Clinical Practice: A Narrative Review
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Sandra Knežević, Francesca Filippi-Arriaga, Andrej Belančić, Tamara Božina, Jasenka Mršić-Pelčić and Dinko Vitezić
Diabetology 2024, 5(4), 406-429; https://doi.org/10.3390/diabetology5040031 - 3 Sep 2024
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Metabolic syndrome (MetS) presents a significant global health challenge, characterized by a cluster of metabolic alterations including obesity, hypertension, insulin resistance/dysglycemia, and atherogenic dyslipidemia. Advances in understanding and pharmacotherapy have added complexity to MetS management, particularly concerning drug interactions and pharmacogenetic variations. Limited
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Metabolic syndrome (MetS) presents a significant global health challenge, characterized by a cluster of metabolic alterations including obesity, hypertension, insulin resistance/dysglycemia, and atherogenic dyslipidemia. Advances in understanding and pharmacotherapy have added complexity to MetS management, particularly concerning drug interactions and pharmacogenetic variations. Limited literature exists on drug–drug–gene interactions (DDGIs) and drug–drug–transporter gene interactions (DDTGIs), which can significantly impact pharmacokinetics and pharmacodynamics, affecting treatment outcomes. This narrative review aims to address the following three key objectives: firstly, shedding a light on the PK metabolism, transport, and the pharmacogenetics (PGx) of medicines most commonly used in the MetS setting (relevant lipid-lowering drugs, antihypertensives and antihyperglycemics agents); secondly, exemplifying potential clinically relevant pharmacokinetic drug interactions, including drug–drug interactions, DDGIs, and DDTGIs; and, thirdly, describing and discussing their potential roles in clinical practice. This narrative review includes relevant information found with the use of interaction checkers, pharmacogenetic databases, clinical pharmacogenetic practice guidelines, and literature sources, guided by evidence-based medicine principles.
Full article
(This article belongs to the Special Issue Risk of Type 2 Diabetes Mellitus: Cardiorenometabolic Syndrome and Its Components)
Open AccessReview
Proteinuric and Non-Proteinuric Diabetic Kidney Disease: Different Presentations of the Same Disease?
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Larissa Fabre, Juliana Figueredo Pedregosa-Miguel and Érika Bevilaqua Rangel
Diabetology 2024, 5(4), 389-405; https://doi.org/10.3390/diabetology5040030 - 2 Sep 2024
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Background: Diabetic kidney disease (DKD) is a leading cause of end-stage kidney disease (ESKD) worldwide. This review examines the potential differences in clinical presentation, outcomes, and management between individuals with proteinuric DKD (P-DKD) and non-proteinuric DKD (NP-DKD). Methods: We analyzed articles published globally
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Background: Diabetic kidney disease (DKD) is a leading cause of end-stage kidney disease (ESKD) worldwide. This review examines the potential differences in clinical presentation, outcomes, and management between individuals with proteinuric DKD (P-DKD) and non-proteinuric DKD (NP-DKD). Methods: We analyzed articles published globally from 2000 and 2024. Results: Individuals with NP-DKD generally have lower blood pressure levels and a more favorable lipid profile. In contrast, histological studies show that P-DKD is associated with more severe glomerulosclerosis, mesangial expansion, arteriolar hyalinosis, interstitial-fibrosis/tubular atrophy, and immune complex deposits. Additionally, those with P-DKD are more likely to develop diabetic retinopathy and have a higher risk of all-cause mortality and progression to ESKD. Strategies to slow DKD progression, applicable to both NP-DKD and P-DKD, include non-pharmacologic and pharmacologic interventions such as renin–angiotensin system blockers, sodium-glucose co-transporter-2 inhibitors, finerenone, and glucagon-like protein receptor agonists. Conclusions: NP-DKD and P-DKD represent different presentations of the same underlying disease.
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Open AccessArticle
Lifestyle Medicine Case Manager Nurses for Type Two Diabetes Patients: An Overview of a Job Description Framework—A Narrative Review
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Giovanni Cangelosi, Stefano Mancin, Paola Pantanetti, Cuc Thi Thu Nguyen, Sara Morales Palomares, Federico Biondini, Marco Sguanci and Fabio Petrelli
Diabetology 2024, 5(4), 375-388; https://doi.org/10.3390/diabetology5040029 - 23 Aug 2024
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Background: Lifestyle medicine (LM) is a contemporary scientific discipline with a multidisciplinary approach. Case Management offers a viable alternative for the care of patients with Type 2 Diabetes (T2D). This study aimed to identify the role and clinical applications of the lifestyle medicine
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Background: Lifestyle medicine (LM) is a contemporary scientific discipline with a multidisciplinary approach. Case Management offers a viable alternative for the care of patients with Type 2 Diabetes (T2D). This study aimed to identify the role and clinical applications of the lifestyle medicine case manager nurse (LMCMN) for T2D patients internationally and to analyze the role of specialist nurses in Italy through a narrative review. A secondary objective was to define a job description (JD) for a future Delphi method. Methods: A narrative review of the literature was conducted using PubMed/Medline, Scopus, and grey literature sources to analyze the international and Italian regulatory contexts. Subsequently, a JD for the LMCMN was developed for application in a future Delphi Study. Results: Nurses play a strategic role in managing T2D, and the LM approach has demonstrated strong evidence of effectiveness. This study developed a specific JD for the LMCMN suitable for both Italian and international contexts. Conclusions: The specific role of the LMCMN is still underdeveloped internationally. In the context of territorial assistance and chronic disease management, this professional is crucial for delivering quality care and shaping health policies that meet community needs.
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(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)
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Open AccessReview
A Review of the Literature Relationship between Psychological Eating Patterns and the Risk of Type 2 Diabetes Mellitus and Metabolic Syndrome
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Filip Mustač, Martina Matovinović, Tin Galijašević, Maja Škarić, Eva Podolski, Toma Perko and Darko Marčinko
Diabetology 2024, 5(4), 365-374; https://doi.org/10.3390/diabetology5040028 - 23 Aug 2024
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Mental health today includes much more than the treatment of psychiatric disorders. More and more interventions aim to bring mental health support closer to people and psychotherapeutic interventions to people with somatic conditions. Since the treatment of people with metabolic syndrome and diabetes
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Mental health today includes much more than the treatment of psychiatric disorders. More and more interventions aim to bring mental health support closer to people and psychotherapeutic interventions to people with somatic conditions. Since the treatment of people with metabolic syndrome and diabetes mellitus type 2 also requires a change in lifestyle, mental health has a prominent role. This overview paper wants to offer a solution after recognizing the given patterns where psychotherapy certainly has a significant and irreplaceable role. Precisely because of this phenomenon, psychological eating patterns associated with diabetes mellitus and hence metabolic syndrome should be studied, and attempts should be made to uncover patterns in occurrence. The aim of this study is to review the literature and consider the connection among diabetes mellitus, metabolic syndrome, and psychological eating patterns such as emotional and compulsive eating, as well as through the lens of food addiction. Furthermore, we have attempted to uncover the role of psychiatry and psychotherapy in the treatment of diabetes mellitus and metabolic syndrome and delve into the complexity of recognizing these patterns and emphasize the importance of a multidisciplinary approach in the treatment of diabetes mellitus and metabolic syndrome.
Full article
(This article belongs to the Special Issue Risk of Type 2 Diabetes Mellitus: Cardiorenometabolic Syndrome and Its Components)
Open AccessArticle
Outcomes for Patients with Diabetic Foot Ulcers Following Transition from Medicaid to Commercial Insurance
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KiBeom Kwon, Taylor A. Brown, Juan C. Arias Aristizábal, David G. Armstrong and Tze-Woei Tan
Diabetology 2024, 5(3), 356-364; https://doi.org/10.3390/diabetology5030027 - 21 Aug 2024
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Objective: This study investigates the outcomes of Medicaid beneficiaries with diabetic foot ulcers (DFUs) who had transitioned to commercial insurance. Methods: We utilized the PearlDiver claims database to identify adult patients diagnosed with a new DFU between 2010 and 2019. The study cohort
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Objective: This study investigates the outcomes of Medicaid beneficiaries with diabetic foot ulcers (DFUs) who had transitioned to commercial insurance. Methods: We utilized the PearlDiver claims database to identify adult patients diagnosed with a new DFU between 2010 and 2019. The study cohort comprised 8856 Medicaid beneficiaries who had at least three years of continuous enrollment after DFU diagnosis. Medicaid beneficiaries who transitioned to Medicare during follow-up were excluded. Adjusted comparisons of outcomes were performed by propensity matching the two groups for age, gender, and Charlson Comorbidity Index (CCI) in a 1:1 ratio. We used logistic regression and Kaplan–Meier estimate to evaluate the association between insurance change (from Medicaid to commercial insurance) and major amputation. Results: Among the 8856 Medicaid beneficiaries with DFUs, 66% (n = 5809) had transitioned to commercial insurance coverage during follow-up. The overall major amputation rate was 2.8% (n = 247), with a lower rate observed in patients who transitioned to commercial insurance compared to those with continuous Medicaid coverage (2.6% vs. 3.2%, p < 0.05). In multivariable analysis, Medicaid beneficiaries who transitioned to commercial insurance had a 27% lower risk of major amputation (study cohort: odds ratios [OR] 0.75, 95% CI 0.56–0.97, p = 0.03; matched cohort: OR 0.65, 95% 0.22, 0.55, p = 0.01) compared to those with continuous Medicaid coverage. Conclusions: Transitioning from Medicaid to commercial insurance may be associated with a lower risk of major amputation among Medicaid beneficiaries with DFUs.
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Open AccessArticle
Impact of Hyperferritinemia on Immune Modulation in Septic Diabetic Patients
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Min-Ji Kim, Eun-Jung Choi and In-Kyu Lee
Diabetology 2024, 5(3), 344-355; https://doi.org/10.3390/diabetology5030026 - 8 Aug 2024
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Diabetes significantly impacts the immune system; however, its role in worsening sepsis prognosis remains poorly understood. This study investigated the effect of hyperferritinemia on immune modulation in septic diabetic patients. A cohort study at Kyungpook National University Hospital stratified sepsis patients by diabetes
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Diabetes significantly impacts the immune system; however, its role in worsening sepsis prognosis remains poorly understood. This study investigated the effect of hyperferritinemia on immune modulation in septic diabetic patients. A cohort study at Kyungpook National University Hospital stratified sepsis patients by diabetes status and followed them for 28 days. Additionally, CD4+ T cells from mice were analyzed for proliferation, apoptosis, and metabolic changes under ferritin treatment. Results from the clinical study showed higher ferritin levels in diabetic patients, and those with lower lymphocyte counts had increased mortality. In the mice study, ferritin inhibited T cell activation and proliferation by shifting metabolism from glycolysis to oxidative phosphorylation without increasing cell death. These findings suggest that the suppression of T cell proliferation due to elevated ferritin levels contributes to an immunosuppressive environment, leading to worse outcomes. In conclusion, hyperferritinemia is a biomarker for sepsis severity, particularly in diabetic patients, highlighting potential therapeutic strategies targeting ferritin levels or glycolytic pathways.
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(This article belongs to the Special Issue Feature Papers in Diabetology 2024)
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Open AccessArticle
The Prescription and Safety of Oral Antidiabetic Drugs in Outpatients with Type 2 Diabetes Mellitus: An Observational, Retrospective, Multicenter Study on the Role of Adherence in a Real-Life Primary Care Setting
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Gianmarco Marcianò, Cristina Vocca, Alessandro Casarella, Luca Gallelli, Vincenzo Rania, Caterina De Sarro, Rita Citraro, Caterina Palleria, Rosa Candida Bianco, Iolanda Fera, Antonietta Greco, Lucia Muraca, Giacinto Nanci, Carmelo Luciano Rossi, Michael Ashour, Bruno D’Agostino and Giovambattista De Sarro
Diabetology 2024, 5(3), 333-343; https://doi.org/10.3390/diabetology5030025 - 7 Aug 2024
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Introduction: Type 2 diabetes mellitus (T2DM) is a common disease burdened with significant morbidity and mortality. Despite the substantial number of new available drug treatments, adherence to therapy and adverse drug reactions (ADRs) are the major constraint in the management of this disease.
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Introduction: Type 2 diabetes mellitus (T2DM) is a common disease burdened with significant morbidity and mortality. Despite the substantial number of new available drug treatments, adherence to therapy and adverse drug reactions (ADRs) are the major constraint in the management of this disease. We evaluated the use, the adherence, and the safety of antidiabetic drugs in patients with T2DM. Methods: We performed an observational, retrospective, multicenter study on medical records of outpatients referred to general practitioners in Catanzaro (Calabria, Italy). Drug adherence was measured considering the packages of antidiabetic drugs prescribed at the time of admission, after three months, and 1 year later. ADRs were evaluated using the Naranjo probability scale. Collected data were analyzed using the Statistical Package for the Social Sciences. Results: During the study, we evaluated 12,170 medical records of seven general practitioners. The most prescribed drug was metformin alone (28.4%) or with other oral antidiabetics (19.6%) and then insulin (n: 354; men 190, women 164). Logistic regression showed an association between T2DM less than or equal to 5 years and low adherence (p = 0.023). During the study, we recorded 26 ADRs that were correlated with sex (women) and insulin treatment. Conclusions: this real-life study shows that patients with T2DM have a high adherence, probably related to their having a low number of ADRs.
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Open AccessArticle
Potential Impact of Metabolic Syndrome Control on Cardiovascular Risk in Elderly Patients with Diabetes: A Cross-Sectional Study
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Tânia Nascimento, Margarida Espírito-Santo, Adriana Gonçalves, Ezequiel Pinto, Ana Luísa De Sousa-Coelho and Maria Dulce Estêvão
Diabetology 2024, 5(3), 321-332; https://doi.org/10.3390/diabetology5030024 - 1 Aug 2024
Abstract
Metabolic syndrome (MS), a complex pathology with features like abnormal body fat distribution, insulin resistance, and dyslipidaemia, contributes to higher cardiovascular (CV) risk. A cross-sectional study including 87 individuals assessed CV risk score in elderly patients with type 2 diabetes and MS in
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Metabolic syndrome (MS), a complex pathology with features like abnormal body fat distribution, insulin resistance, and dyslipidaemia, contributes to higher cardiovascular (CV) risk. A cross-sectional study including 87 individuals assessed CV risk score in elderly patients with type 2 diabetes and MS in Algarve, Portugal. The 10-year CV risk score was estimated using the ADVANCE risk score calculator. The reductions in CV risk score were estimated by adjusting the data inputted on the online tool to achieve systolic blood pressure (SBP) <130 or <120 mmHg, and LDL cholesterol <70 mg/dL Beyond waist circumference, the mean number of clinical features of MS was 3.14 ± 0.84, without significant sex differences. The mean CV risk score was 22.5% (CI: 20.3–24.7). Sex-specific analysis showed higher risk score in males (24.2%, CI: 21.3–27.0) vs. females (19.7%, CI: 16.2–23.3; p = 0.028). Hypothetical risk score reductions show that lowering SBP to <130 mmHg could significantly lower the risk score by an average of 9.2% (CI: 7.7–10.7), whereas 34.5% of the participants would be out of the diagnostic criteria for MS. When comparing each potential intervention with current risk score, all interventions significantly reduce the 10-year CV risk score. The study highlights the potential of blood pressure control in reducing CV risk score and the importance of multifaceted risk score reduction strategies.
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(This article belongs to the Special Issue Risk of Type 2 Diabetes Mellitus: Cardiorenometabolic Syndrome and Its Components)
Open AccessReview
Metabolic Syndrome and Pharmacological Interventions in Clinical Development
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Eugen Javor, David Šarčević and Arnes Rešić
Diabetology 2024, 5(3), 300-320; https://doi.org/10.3390/diabetology5030023 - 23 Jul 2024
Abstract
Metabolic syndrome prevalence is between 24 and 27% and poses a significant risk for the development of atherosclerotic cardiovascular disease (ASCVD), type 2 diabetes (T2D), or other comorbidities. Currently, no drugs are approved for metabolic syndrome treatment itself, so the risk factors are
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Metabolic syndrome prevalence is between 24 and 27% and poses a significant risk for the development of atherosclerotic cardiovascular disease (ASCVD), type 2 diabetes (T2D), or other comorbidities. Currently, no drugs are approved for metabolic syndrome treatment itself, so the risk factors are treated with therapies approved for cardiac and metabolic conditions. These are approved drugs for dyslipidemia treatment such as statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, cornerstone antihypertensive drugs, or novel class glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1 RA) for T2D and overweight or obesity treatment. We have also evaluated new pharmacological interventions in clinical development that have reached Phase 2 and/or Phase 3 randomized clinical trials (RCTs) for the management of the risk factors of metabolic syndrome. In the pipeline are glucose-dependent insulinotropic polypeptide (GIP), GLP-1, glucagon receptor (GCGR), amylin agonists, and a combination of the latter for T2D and overweight or obesity treatment. Non-entero-pancreatic hormone-based therapies such as ketohexokinase (KHK) inhibitor, growth differentiation factor 15 (GDF15) agonists, monoclonal antibodies (mAbs) as activin type II receptors (ActRII) inhibitors, and a combination of anti-α-myostatin (GFD8) and anti-Activin-A (Act-A) mAbs have also reached Phase 2 or 3 RCTs in the same indications. Rilparencel (Renal Autologous Cell Therapy) is being evaluated in patients with T2D and chronic kidney disease (CKD) in a Phase 3 trial. For dyslipidemia treatment, novel PCSK9 inhibitors (oral and subcutaneous) and cholesteryl ester transfer protein (CETP) inhibitors are in the final stages of clinical development. There is also a surge of a new generation of an antisense oligonucleotide (ASO) and small interfering RNA (siRNA)-targeting lipoprotein(a) [Lp(a)] synthesis pathway that could possibly contribute to a further step forward in the treatment of dyslipidemia. For resistant and uncontrolled hypertension, aldosterone synthase inhibitors and siRNAs targeting angiotensinogen (AGT) messenger RNA (mRNA) are promising new therapeutic options. It would be interesting if a few drugs in clinical development for metabolic syndrome such as 6-bromotryptophan (6-BT), vericiguat, and INV-202 as a peripherally-acting CB1 receptor (CB1r) blocker would succeed in finally gaining the first drug approval for metabolic syndrome itself.
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(This article belongs to the Special Issue Risk of Type 2 Diabetes Mellitus: Cardiorenometabolic Syndrome and Its Components)
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Open AccessArticle
Emotional Eating Is Associated with T2DM in an Urban Turkish Population: A Pilot Study Utilizing Social Media
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Aleksandra S. Kristo, Kübra İzler, Liel Grosskopf, Jordan J. Kerns and Angelos K. Sikalidis
Diabetology 2024, 5(3), 286-299; https://doi.org/10.3390/diabetology5030022 - 11 Jul 2024
Abstract
Lifestyle behaviors and their potential effects on diabetes are being investigated for optimal diabetes management. In patients with type 2 diabetes mellitus (T2DM), the necessary dietary modifications extend to psychological components for consideration. This study aimed to determine the eating behavior of T2DM
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Lifestyle behaviors and their potential effects on diabetes are being investigated for optimal diabetes management. In patients with type 2 diabetes mellitus (T2DM), the necessary dietary modifications extend to psychological components for consideration. This study aimed to determine the eating behavior of T2DM patients with different sociodemographic characteristics in an urban Turkish population. The Dutch Eating Behavior Questionnaire (DEBQ) was distributed via social media and a smartphone application to 108 T2DM patients, 58 males and 50 females, age 26–40 years (20 individuals, 18.6%) and over 40 years (88 individuals, 81.4 %). Basic component factor analysis varimax rotation was used for the item-total correlation coefficient. The 26–40 years age group exhibited high correlation for both restrained and emotional eating behavior (r > 0.8), while participants over 40 years displayed medium correlation for restrained eating and high correlation for emotional eating (r = 0.6–0.8). Compared to married and single participants, participants with “other” marital status showed significant correlation with all eating behavior categories (r > 0.8). Married participants were less correlated with all categories compared to single participants. Participants with lower education levels exhibited high correlation (r > 0.8) for all forms of eating, more so compared to those with higher levels of education attained. Overweight patients demonstrated moderately high (r = 0.4–0.6) restrictive eating correlation, while normal weight and obese patients exhibited higher correlation (r = 0.6–0.8) for emotional and restrained eating compared to overweight patients. Regardless of demographic factors, when all participants were combined, the strongest correlation was found to be with emotional eating compared to other types of eating.
Full article
(This article belongs to the Special Issue Dietary Patterns and Risk of Type 2 Diabetes)
Open AccessReview
The Use of Insulin Pen Needles: The Italian Society of Metabolism, Diabetes, and Obesity (SIMDO) Consensus
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Giancarlo Tonolo, Ariella DeMonte, Maria Antonietta Taras, Alessandro Scorsone, Patrizio Tatti, Battistina Pittui, Salvatore Turco and Riccardo Trentin
Diabetology 2024, 5(3), 271-285; https://doi.org/10.3390/diabetology5030021 - 5 Jul 2024
Abstract
A correct injection technique is essential in order to ensure the effectiveness of insulin and to achieve good metabolic control, and the use of suitable needles is fundamental. Today, technological evolution has transformed insulin needles into innovative tools able to guarantee an effective
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A correct injection technique is essential in order to ensure the effectiveness of insulin and to achieve good metabolic control, and the use of suitable needles is fundamental. Today, technological evolution has transformed insulin needles into innovative tools able to guarantee an effective and safe administration of insulin, to reduce local complications, such as lipodystrophies that are an obstacle to the effectiveness of the treatment itself, and to minimize the pain of the injection, a crucial factor in the acceptance of therapy and for compliance. The steering committee of the scientific society SIMDO has commissioned the scientific committee and some members of the board to draw up an official SIMDO point of view/consensus on the use of insulin needles. In this way, a group that has combined the experience gained in their field of expertise—diabetologists operating in the public and private sectors, nurses, psychologists, and patients—was set up. The aim is to give indications regarding insulin injection techniques, combining themes such as technology innovation, education in self-management, and psychological support for the patient into a unified approach based on the priority area of patient quality of life. The document will provide operational recommendations that integrate the directions regarding the standards of care for diabetes resulting from the most recent scientific acquisitions with the concept of quality at 360°, as it emerged from the point of view of all the operators involved, but with the patient’s interests as a central focal point.
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(This article belongs to the Special Issue Feature Papers in Diabetology 2024)
Open AccessReview
The Influence of Plant-Based Diets on Metabolic Syndrome
by
Inês Fernandes, Melissa Mariana, Margarida Lorigo and Elisa Cairrao
Diabetology 2024, 5(3), 255-270; https://doi.org/10.3390/diabetology5030020 - 3 Jul 2024
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The magnification of Western eating habits has contributed to a large increase in the development of several diseases and conditions, namely cardiovascular disease, obesity, dyslipidemia, and hyperglycemia. These are part of a cluster of metabolic factors involved in metabolic syndrome. However, there are
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The magnification of Western eating habits has contributed to a large increase in the development of several diseases and conditions, namely cardiovascular disease, obesity, dyslipidemia, and hyperglycemia. These are part of a cluster of metabolic factors involved in metabolic syndrome. However, there are new dietary patterns more focused on the consumption of plant-based foods. Thus, the aim of this review was to investigate the impact of plant-based diets on metabolic syndrome and to achieve the inflammatory mediators and the antioxidant effects involved in this potential health benefits effect. Advanced research was performed for articles published in the last 10 years, which were analyzed and selected according to the defined inclusion and exclusion criteria. Of the articles analyzed, the majority supported the positive impact of plant-based diets on metabolic syndrome. Furthermore, several studies also showed that these diets appear to have an anti-inflammatory and antioxidant role. Thus, plant-based diets appear to have health benefits, contributing to the prevention of metabolic syndrome, and improving the cardiovascular and metabolic markers’ profile, mainly when including healthy foods. The total exclusion of animal source foods (especially meat and fish) from the diet, as well as the consumption of processed and additive plant-based foods, may contribute to an increased prevalence of metabolic syndrome.
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Open AccessArticle
Quantitative Analysis of Different Foveal Avascular Zone Metrics in Healthy and Diabetic Subjects
by
Ouafa Sijilmassi
Diabetology 2024, 5(3), 246-254; https://doi.org/10.3390/diabetology5030019 - 30 Jun 2024
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The primary aim of this study was to assess the size and shape of the Foveal Avascular Zone (FAZ) in patients with type 2 diabetes mellitus compared to healthy subjects. The study used 80 OCTA images from the FAZID dataset. The FAZ size
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The primary aim of this study was to assess the size and shape of the Foveal Avascular Zone (FAZ) in patients with type 2 diabetes mellitus compared to healthy subjects. The study used 80 OCTA images from the FAZID dataset. The FAZ size was measured by its area, perimeter, and maximum/minimum Feret diameters. The shape was assessed using the axial ratio, circularity, roundness, and solidity. These metrics were calculated automatically using Matlab® R2020b. Statistical analysis was performed using SPSS statistical software version 28.0, with a p-value of less than 0.01 considered significant. The results showed that the FAZ area was significantly larger in diabetic eyes (mean = 0.50 mm2) compared to control eyes (mean = 0.37 mm2), with a p-value of less than 0.01. Both the maximum and minimum diameters of the FAZ were also significantly larger in diabetic groups compared to the control group. Parameters associated with FAZ’s shape were significantly smaller in the diabetic groups than in the control group, except for the axial ratio. The main finding of this study is that diabetic eyes without clinically detectable diabetic retinopathy exhibit morphological changes and irregularities at the FAZ border.
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Open AccessReview
Overweight and Obesity in Adults with Type 1 Diabetes: A Growing Challenge
by
Sanja Klobučar, Dijana Detel, Miljenka Igrec, Ajda Bergoč, Valentina Rahelić and Dario Rahelić
Diabetology 2024, 5(3), 234-245; https://doi.org/10.3390/diabetology5030018 - 24 Jun 2024
Abstract
The prevalence of obesity in adults with type 1 diabetes is increasing and reflects the rates of the general adult population. The coexistence of overweight or obesity and type 1 diabetes poses a major challenge to effective glycemic and weight management. In addition,
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The prevalence of obesity in adults with type 1 diabetes is increasing and reflects the rates of the general adult population. The coexistence of overweight or obesity and type 1 diabetes poses a major challenge to effective glycemic and weight management. In addition, individuals living with T1D and overweight or obesity are at greater cardiometabolic risk and are more prone to develop chronic complications in comparison to normal weight individuals with type 1 diabetes. Although obesity represents a growing challenge in the type 1 diabetes population, awareness of this issue is still low. This review provides a summary of current data on prevalence trends, causes, current strategies, and challenges in managing obesity in adults with type 1 diabetes.
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Open AccessArticle
The Utility of Annual Reassessment of the International Working Group on the Diabetic Foot Diabetes-Related Foot Ulcer Risk Classification in the Primary Care Setting—A Cohort Study
by
Matilde Monteiro-Soares, José Dores, Cristina Alves-Palma, Susana Galrito and Daniela Ferreira-Santos
Diabetology 2024, 5(2), 223-233; https://doi.org/10.3390/diabetology5020017 - 4 Jun 2024
Abstract
Background: We assessed the pertinence of updating the International Working Group on the Diabetic Foot (IWGDF) risk classification yearly in people with diabetes by quantifying the changes in the risk group and its accuracy in identifying those developing an ulcer (DFU) in a
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Background: We assessed the pertinence of updating the International Working Group on the Diabetic Foot (IWGDF) risk classification yearly in people with diabetes by quantifying the changes in the risk group and its accuracy in identifying those developing an ulcer (DFU) in a primary care setting. Methods: In our retrospective cohort study, we included all people with diabetes with a foot assessment registry between January 2016 and December 2018 in the Baixo Alentejo Local Health Unit. Foot-related data were collected at baseline after one and two years. DFU and/or death until December 2019 were registered. The proportion of people changing their risk status each year was calculated. Accuracy measures of the IWGDF classification to predict DFU occurrence at one, two, and three years were calculated. Results: A total of 2097 people were followed for three years, during which 0.1% died and 12.4% developed a DFU. After two years, 3.6% of the participants had progressed to a higher-risk group. The IWGDF classification presented specificity values superior to 90% and negative predictive values superior to 99%. Conclusion: Foot risk status can be safely updated every two years instead of yearly, mainly for those at very low risk. The IWGDF classification can accurately identify those not at risk of DFU.
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(This article belongs to the Special Issue Exclusive Papers Collection of Editorial Board Members in Diabetology)
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Open AccessArticle
A Resource-Efficient Plantar Pressure Evaluation System for Diabetic Foot Risk Assessment
by
Madison Reddie and Daniel Frey
Diabetology 2024, 5(2), 206-222; https://doi.org/10.3390/diabetology5020016 - 22 May 2024
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Diabetic foot complications constitute a large and rapidly growing global health problem, causing one million lower-extremity amputations annually. These amputations are typically preceded by preventable diabetic foot ulcers (DFUs). However, 80% of the world’s diabetics now reside in low- and middle-income countries, where
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Diabetic foot complications constitute a large and rapidly growing global health problem, causing one million lower-extremity amputations annually. These amputations are typically preceded by preventable diabetic foot ulcers (DFUs). However, 80% of the world’s diabetics now reside in low- and middle-income countries, where many healthcare settings lack the resources required to implement recommended DFU risk assessment and prevention strategies. There is an unmet need for a more resource-efficient DFU risk assessment method. In this study, a low-cost, purely mechanical plantar pressure evaluation device was designed toward this end. The device consists of a grid of plastic bistable compliant mechanisms, which present a visual series of binary outputs in response to applied pressure. By having diabetic patients step on the device, non-specialist healthcare providers can easily assess patients’ plantar pressures, which are predictive of future DFUs. A prototype was fabricated and pilot-tested with 41 healthy subjects. It demonstrated a sensitivity of 25.6%, although sensitivity reached 60% for heavier subjects. Sensitivity could likely be significantly improved by lowering the device’s profile and increasing the sensing area. Strained health systems may then be able to use this device to allocate scarce healthcare resources more efficiently to prevent costly DFUs and amputations.
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Risk of Type 2 Diabetes Mellitus: Cardiorenometabolic Syndrome and Its Components
Guest Editors: Andrej Belančić, Bojan Jelaković, Martina MatovinovićDeadline: 15 October 2024
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Dietary Patterns and Risk of Type 2 Diabetes
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Insulin Injection Techniques and Skin Lipodystrophy
Guest Editors: Sandro Gentile, Felix StrolloDeadline: 30 November 2024
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Exclusive Papers Collection of Editorial Board Members in Diabetology
Guest Editor: Sathish ThirunavukkarasuDeadline: 31 December 2024