Diabetes Therapy最新文献

{"title":"Advances in Imaging Techniques for Assessing Myocardial Microcirculation in People with Diabetes : An Overview of Current Techniques, Emerging Techniques, and Clinical Applications.","authors":"Tine Willum Hansen, Rasmus S Ripa","doi":"10.1007/s13300-025-01710-1","DOIUrl":"https://doi.org/10.1007/s13300-025-01710-1","url":null,"abstract":"<p><p>Microangiopathy is a key complication of diabetes, adversely effecting several organs including the heart, kidneys, eyes, and nerves. This review focuses on myocardial microvascular dysfunction, a condition characterized by altered vasomotion and long-term structural changes to coronary arterioles, resulting in impaired regulation of blood flow in response to varying oxygen demands of cardiomyocytes. Presence of myocardial microvascular dysfunction is associated with increased risk of cardiovascular disease, even in the absence of obstructive coronary artery disease. Several noninvasive imaging techniques to assess coronary physiology have significantly enhanced our understanding of the myocardial microcirculation. These methods allow for detailed visualization and quantification of blood flow, endothelial function, and inflammation in the microvasculature, providing critical insights into the early stages of microvascular disease in diabetes. A significant area of development is the use of advanced hybrid imaging techniques such as positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI). The integration of advanced imaging technologies with artificial intelligence is also a key future direction. Overall, these advancements aim to improve the early detection and management of microvascular complications in diabetes, ultimately enhancing outcomes and quality of life. The aim of this review is to provide an overview of both established and emerging noninvasive imaging techniques for assessing myocardial microvascular dysfunction.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Educators: Understanding the Role of Finerenone in Chronic Kidney Disease Associated with Type 2 Diabetes Mellitus.","authors":"Anne M Komé, Anita Yang, Patrick Gee, Klara R Klein","doi":"10.1007/s13300-025-01705-y","DOIUrl":"https://doi.org/10.1007/s13300-025-01705-y","url":null,"abstract":"<p><p>People living with type 2 diabetes mellitus (T2DM) are at risk of developing diabetes-related complications such as chronic kidney disease (CKD). Screening for CKD is considered the standard of diabetes care, but less than half of people living with diabetes in the United States receive guideline-directed kidney disease testing. Despite recent pharmacologic advances for the treatment of this condition, insufficient screening delays both diagnosis and treatment of diabetes-related CKD and increases the risk of poor outcomes. The nonsteroidal mineralocorticoid receptor antagonist finerenone is an orally administered drug that, when taken with the maximum tolerated dose of a renin-angiotensin-aldosterone system inhibitor, can provide kidney and cardiovascular benefits for people living with T2DM-related CKD. Yet, uptake of this drug has been slow. Increasing awareness of finerenone may encourage its use in clinical practice. Diabetes educators are healthcare professionals (HCPs) with extensive diabetes care experience who encourage diabetes self-management and provide patients with education on the prevention of diabetes-related complications. Diabetes educators bridge knowledge and care gaps among other HCPs by facilitating communication between members of the care team and raising awareness on the importance of CKD prevention and screening. Additionally, diabetes educators reinforce the clinical evidence behind available treatments to promote adherence to guidelines. Here, the evidence for finerenone in T2DM-related CKD and the role of the diabetes educator from both patient and HCP perspectives are reviewed.Graphical abstract available for this article.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Phase 3 Study Evaluating the Efficacy and Safety of Alogliptin in Pediatric Participants with Type 2 Diabetes Mellitus.","authors":"Xuejun Victor Peng, Georgeanna Klingensmith, Daniel S Hsia, Yunlong Xie, Richard Czerniak, William V Tamborlane, Amy S Shah","doi":"10.1007/s13300-025-01700-3","DOIUrl":"https://doi.org/10.1007/s13300-025-01700-3","url":null,"abstract":"<p><strong>Introduction: </strong>There is an unmet need for pharmacological therapies for children with type 2 diabetes mellitus (T2DM). We assessed the efficacy and safety of an oral dipeptidyl peptidase-4 inhibitor, alogliptin, 25 mg once daily (QD), as a potential treatment for pediatric patients with T2DM.</p><p><strong>Methods: </strong>This phase 3, 52-week, multicenter, randomized, double-blind, placebo-controlled trial was conducted in children and adolescents (10-17 years old) with T2DM. Participants had glycosylated hemoglobin (HbA1c) ≥ 6.5% at baseline (≥ 6.5% to < 11% without treatment or on metformin alone; ≥ 7.0% to < 11% on insulin alone or in combination with metformin). Where required, participants underwent prerandomization stabilization of their background metformin and/or insulin therapy. All received diabetes education and home glucose-monitoring training (during screening, prerandomization stabilization, and specified visits through week 26). Participants were then stratified based on previous antihyperglycemic therapy for 12 weeks before screening into schedule A (antihyperglycemic treatment-naïve) or B (metformin and/or insulin). The primary efficacy endpoint was change in HbA1c levels from baseline at week 26. Safety was assessed as a secondary endpoint at week 52.</p><p><strong>Results: </strong>Overall, 152 participants (median age, 14 years; 68.9% female) were randomized (1:1) to receive either alogliptin (n = 75) or placebo (n = 77). The majority were white (58.3%), had a body mass index of ≥ 30 kg/m² (60.3%), and had received previous antihyperglycemic therapy (82.1%). The difference in HbA1c levels from baseline to week 26 between the alogliptin and placebo groups (least squares mean change [95% confidence interval]) was 0.10 (- 0.63, 0.83; p = 0.78). There was no difference in efficacy endpoints between alogliptin and placebo across both subgroups. No new safety concerns were observed with alogliptin treatment.</p><p><strong>Conclusion: </strong>Alogliptin 25 mg QD did not significantly improve glycemic control versus placebo in pediatric patients with T2DM. Alogliptin treatment was safe and well tolerated, and no new safety concerns were observed in this study.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT02856113; EudraCT: 2015-000208-25.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Hybrid Closed Loop Algorithm Use in Type 1 Diabetes: The French MiniMed™ Glycemic Control and Quality of Life Study.","authors":"Laurence Kessler, Charles Thivolet, Alfred Penfornis, Didier Gouet, Christine Coffin, Myriam Moret, Sophie Borot, Saïd Bekka, Emmanuel Sonnet, Michael Joubert, Sandrine Lablanche, Geoffrey Burtin, Fabio Di Piazza, Tim van den Heuvel, Ohad Cohen","doi":"10.1007/s13300-024-01673-9","DOIUrl":"10.1007/s13300-024-01673-9","url":null,"abstract":"<p><strong>Introduction: </strong>The MiniMed™ 780G system uses an advanced hybrid closed loop algorithm to improve outcomes in people with type 1 diabetes (T1D). The MiniMed™ 780G Glycemic Control and Quality of Life (EQOL) study aimed to provide routine clinical practice data on system effectiveness and associated patient-reported outcomes (PROs) in France.</p><p><strong>Methods: </strong>Individuals aged ≥ 7 years with T1D were enrolled. A 14-day run-in phase in Manual mode preceded a 12-month study phase using Auto mode. The primary endpoint was absolute change in time in range (TIR) from baseline to 6 months. Secondary endpoints included changes in glycemic targets, glycated hemoglobin (HbA1c), and hypoglycemia. PROs included treatment satisfaction, quality of life (QoL), and fear of hypoglycemia.</p><p><strong>Results: </strong>Two-hundred seventy participants formed the intent-to-treat population at 6 months. TIR increased by 11.8 percentage points (standard deviation [SD] 8.96, 95% confidence interval 10.7 to 12.9, p < 0.0001), from 61.9% (SD 11.0) to 73.7% (SD 7.4), equivalent to 2.8 h per day more in range. Time < 70 mg/dL decreased by 1.5 percentage points (p < 0.0001), from 4.0% to 2.5%. All glycemic parameters significantly improved. HbA1c decreased by 0.52% and 0.42% at 6 and 12 months, respectively. More patients met glycemic targets, while severe hypoglycemia was reduced. At 12 months, treatment satisfaction increased across age groups, and QoL improved in adults. Fear of hypoglycemia decreased in adults and children.</p><p><strong>Conclusion: </strong>In France, people with T1D initiating the MiniMed™ 780G system demonstrated sustained TIR and HbA1c improvements. System usage reduced hypoglycemia and fear of hypoglycemia, and increased treatment satisfaction.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT04308291.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"413-427"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Financial Incentives as a Tool to Increase Medication Adherence for Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.","authors":"Debra Winberg, Tiange Tang, Zachary Ramsey, Alessandra N Bazzano, Elizabeth Nauman, Jian Li, Yilu Lin, Lizheng Shi","doi":"10.1007/s13300-025-01694-y","DOIUrl":"10.1007/s13300-025-01694-y","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) is a common chronic disease with high rates of complications. Although there are successful treatments, rates of medication non-adherence remain high. This study aims to evaluate the impact of financial incentives on medication adherence in people living with T2DM.</p><p><strong>Methods: </strong>PubMed, Scopus, and Embase were searched via the terms \"medication adherence,\" \"diabetes,\" and \"financial/economic incentive.\" Data on study characteristics, incentive type, and impact were extracted. The outcome measures included the proportion of days covered (PDC), mean possession ratio (MPR), percent adherent (PDC/MPR > 80%), and others. Two pooled Bayesian meta-analyses were conducted, analyzing the mean differences in PDC or MPR and the percentage of adherent patients (MPR > 80%).</p><p><strong>Results: </strong>The search yielded 8244 results with 126 full-text articles reviewed. In total, 22 studies that met the inclusion criteria were included. Among these 22 studies, 16 reported that financial incentives significantly increased medication adherence in all, four reported that they did not lead to significant changes in adherence, and two studies reported differing results per subgroup. For the pooled meta-analyses, the effect of financial incentives on percent adherent was significant in three studies (weighted Cohen's D: 0.03, P = 0.02) and in the ten studies assessed PDC/MPR, financial incentives significantly increased adherence (weighted Cohen's D: 0.02, 95%, P < 0.01).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis demonstrated that financial incentives lead to statistically significant but possibly clinically irrelevant increases in medication adherence for patients living with T2DM.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"527-545"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Serum α-Klotho Levels and Diabetic Kidney Disease Prevalence in Middle-Aged and Elderly US Patients with Diabetes: A Cross-Sectional Study Using NHANES 2007-2016 Data.","authors":"Shaowei Ding, Jinrui Sun, Lin Wang, Ling Wu, Weijing Liu","doi":"10.1007/s13300-024-01683-7","DOIUrl":"10.1007/s13300-024-01683-7","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic kidney disease (DKD) represents a significant microvascular complication associated with diabetes and serves as a major contributor to end-stage renal disease. While many studies have highlighted the renal protective effects of the anti-aging protein Klotho, the potential link between Klotho and DKD within individuals with diabetes remains a subject of debate, and comprehensive studies utilizing large population-based databases are still needed.</p><p><strong>Methods: </strong>This cross-sectional study, which is representative of the national population, examined data from US patients with diabetes aged 40-79 years, collected during the 2007-2016 cycles of the National Health and Nutrition Examination Survey (NHANES). Serum α-Klotho levels were determined using enzyme-linked immunosorbent assay (ELISA) techniques. Given that serum Klorho levels are not normally distributed, our analysis is based on values converted from the natural logarithm of Klotho. To assess the association between Klotho levels and the prevalence of DKD, multivariate regression models were utilized, taking into account potential confounding factors. Furthermore, we applied smooth curve fitting and segmented regression analyses to investigate possible threshold effects and identify inflection points. Subgroup analyses and cross-tests were performed to assess the consistency of associations in the general population.</p><p><strong>Results: </strong>The investigation included 4490 individuals with diabetes, with an median age of 60.0 years and 48.2% of them being male. Among these participants, 1352 (30.1%) were diagnosed with DKD. The fully adjusted model (model 3) indicated a significant inverse relationship between Klotho levels and DKD prevalence. Statistical analysis showed that in fully adjusted model 3, each 1-unit increase in log-transformed Klotho was associated with a 42% reduction in DKD prevalence [OR 0.58, 95% CI (0.42, 0.80), p = 0.002]. Further analysis using smooth curve fitting revealed a U-shaped relationship between Klotho levels and DKD prevalence, with an inflection point at 6.82 (after natural logarithm conversion).</p><p><strong>Conclusions: </strong>This study identified a U-shaped relationship between Klotho levels and the prevalence of DKD in middle-aged and older adults with diabetes in the USA, with an inflection point of 6.82 (after natural logarithm conversion). Prior to this threshold, the relationship between Klotho and DKD prevalence was negatively correlated, while after the inflection point, the relationship became positive. Future studies are recommended to investigate the causal relationship behind this relationship.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"499-511"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young Adults with Type 1 Diabetes' Clinical Outcomes and Satisfaction Related to the Use of Videoconferencing for Type 1 Diabetes Healthcare: A Narrative Review.","authors":"Steven James, Mahira Saiyed, Olive James, Rutul Gokalani, Megan Paterson, Kiran Mejia Mehta, Emma Klatman, Judy Craft, Roopa Mehta","doi":"10.1007/s13300-024-01688-2","DOIUrl":"10.1007/s13300-024-01688-2","url":null,"abstract":"<p><strong>Introduction: </strong>Young adulthood is well documented as being a particularly challenging area of type 1 diabetes (T1D) healthcare. Many young adults with T1D (YAT1D) are distracted from effective disease self-management; T1D healthcare service engagement can be problematic and inconsistent, and high rates of unplanned healthcare contacts prevail. Video conferencing use can facilitate services to be flexible and responsive. We aimed to evaluate clinical outcomes and satisfaction related to the use of videoconferencing for T1D healthcare in YAT1D.</p><p><strong>Methods: </strong>A quantitative narrative review was undertaken, using a systematic process. PubMed, Scopus and CINAHL were searched (until August 2023) to identify relevant articles, using Medical Subject Headings and keywords. A total of 12 records (eight studies) from four countries were retrieved.</p><p><strong>Results: </strong>Ten records considered clinical outcomes; eight of these records focused on the effectiveness of videoconferencing as part of routine care. Findings largely demonstrate benefits to glycaemic control, particularly when used during the COVID-19 pandemic; no data were available relating to the impact of videoconferencing use on blood pressure and lipid control in YAT1D. Four records considered satisfaction with use of videoconferencing, with data indicating YAT1D were satisfied with the use of videoconferencing technology.</p><p><strong>Conclusions: </strong>There is a need to configure T1D healthcare services to incorporate and offer use of videoconferencing technology, where applicable, appropriate and acceptable for YAT1D, and feasible and workable for service providers. This will require some adjustments from healthcare systems and possible changes to funding mechanisms.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"329-348"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Survey on Adults with Type 1 Diabetes and their Caregivers: Insights into Personal Experience and Needs for Improving Diabetes Care.","authors":"Alfred Penfornis, Su Down, Antoine Seignez, Alizé Vives, Mireille Bonnemaire, Bernhard Kulzer","doi":"10.1007/s13300-024-01685-5","DOIUrl":"10.1007/s13300-024-01685-5","url":null,"abstract":"<p><strong>Introduction: </strong>Type 1 diabetes (T1D) requires constant self-management and substantially impacts daily life. We surveyed the experiences/burdens of people with T1D (PWD) and their caregivers.</p><p><strong>Methods: </strong>An online survey of PWD/caregivers (aged ≥ 18 years) living in five European countries was conducted from July to August 2021. The survey included questions on the impact of T1D on physical and mental abilities, the frequency of hypoglycemic and hyperglycemic episodes and the impact of T1D on the daily lives of PWD.</p><p><strong>Results: </strong>Respondents included 458 PWD and 54 caregivers. The main impacts of T1D included fatigue (50% of PWD rated a high/very high impact), a hindrance to daily activities (43%), feeling different than others (42%), and anxiety (40%). The perceived impact of complication risk was significantly lower for PWD paying more attention to controlling their disease (p < 0.001). Most caregivers (80%) reported feeling more anxious than the PWD about their T1D complications. Hypoglycemia/hyperglycemia was a significant predictor of perceived distress owing to T1D. Most PWD (68%) would have liked more psychological support. Over half of respondents (PWD: 53%, caregivers: 56%) felt they had insufficient knowledge about T1D. Acceptance, positivity, and self-organization are the main strategies recommended by PWD/caregivers for living with T1D.</p><p><strong>Conclusions: </strong>T1D remains a significant burden for PWD/caregivers, and more educational and psychological support for T1D management is required.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"471-484"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: The Long-Term Cost-Effectiveness of Tirzepatide 5 mg versus Dulaglutide 0.75 mg for the Treatment of People with Type 2 Diabetes in Japan.","authors":"Toshihiko Aranishi, Ataru Igarashi, Kazuo Hara, Beatrice Osumili, Zhihong Cai, Aska Mizogaki, Manaka Sato, Masakazu Takeuchi, Alice Minghetti, Barnaby Hunt, Takashi Kadowaki","doi":"10.1007/s13300-025-01697-9","DOIUrl":"10.1007/s13300-025-01697-9","url":null,"abstract":"","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"447"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Inflammation in the Pathogenesis of Diabetic Peripheral Neuropathy: New Lessons from Experimental Studies and Clinical Implications.","authors":"Theodoros Panou, Evanthia Gouveri, Djordje S Popovic, Dimitrios Papazoglou, Nikolaos Papanas","doi":"10.1007/s13300-025-01699-7","DOIUrl":"10.1007/s13300-025-01699-7","url":null,"abstract":"<p><p>Diabetic peripheral neuropathy (DPN) is one of the most frequent complications of diabetes mellitus (DM). Its pathogenesis is still not entirely clear. Inflammation is increasingly being appreciated as a key factor in its development and progression. The aim of this review was to outline current evidence from experimental research on the role of inflammation in the pathogenesis of DPN and to suggest emerging clinical implications. Beyond commonly assessed interleukins, chemokines and tumour necrosis factor alpha (TNFα), several novel underlying mechanisms and potential therapeutic targets have been unravelled. Pathogenesis is also influenced by dietary patterns, such as iron supplementation. Furthermore, the impact of the inflammasome nucleotide-binding oligomerisation domain-like receptor pyrin domain-containing protein 3 (NLPR3) is gaining importance. The same holds true for inflammatory pathways, such as the Toll-like receptor (TLR)-associated pathways or the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway. SIRTuins are also of importance. DPN is associated with changes in macrophage polarisation. In addition, several metalloproteinases are emerging as contributors, although data is still limited. Finally, miRNAs (e.g. miR146a) are strongly linked with DPN by acting in several inflammatory pathways. However, we still need confirmation of preliminary research findings. It is hoped that new knowledge will lead to new therapeutic approaches, including stem cell-based or exosome-based therapies.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"371-411"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}