Diabetes/Metabolism Research and Reviews最新文献

{"title":"Donor fat-to-muscle ratio and kidney transplant outcomes: A proposition of metabolic memory","authors":"Youn Kyung Kee,&nbsp;Juhan Lee,&nbsp;Bo Young Nam,&nbsp;Young Su Joo,&nbsp;Shin-Wook Kang,&nbsp;Kyu Ha Huh,&nbsp;Jung Tak Park","doi":"10.1002/dmrr.3781","DOIUrl":"10.1002/dmrr.3781","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The impact of donor abdominal fat-to-muscle ratio (FMR) on kidney transplant (KT) outcomes was assessed. Given the transient nature of the donor's metabolic environment in transplant recipients, this study investigated the capacity of body composition to induce metabolic memory effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>KT patients (<i>n</i> = 895) who received allografts from living donors (2003–2013) were included. Donor fat and muscle were quantified using pre-KT abdominal computed tomography scans. Patients were categorised into donor FMR tertiles and followed up for graft outcomes. Additionally, genome-wide DNA methylation analysis was performed on 28 kidney graft samples from KT patients in the low- and high-FMR groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean recipient age was 42.9 ± 11.4 years and 60.9% were males. Donor FMR averaged 1.67 ± 0.79. Over a median of 120.9 ± 42.5 months, graft failure (<i>n</i> = 127) and death-censored graft failure (<i>n</i> = 109) were more frequent in the higher FMR tertiles. Adjusted hazard ratios for the highest versus lowest FMR tertile were 1.71 (95% CI, 1.06–2.75) for overall graft failure and 1.90 (95% CI, 1.13–3.20) for death-censored graft failure. Genome-wide DNA methylation analysis identified 58 differentially methylated regions (<i>p</i> &lt; 0.05, |Δ<i>β</i>| &gt; 0.2) and 35 genes showed differential methylation between the high- (FMR &gt;1.91) and low-FMR (FMR &lt;1.27) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Donors with increased fat and reduced muscle composition may negatively impact kidney allograft survival in recipients, possibly through the transmission of epigenetic changes, implying a body-composition-related metabolic memory effect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain alterations in regions associated with end-organ diabetic microvascular disease in diabetes mellitus: A UK Biobank study","authors":"Jamie Burgess,&nbsp;Christophe de Bezenac,&nbsp;Simon S. Keller,&nbsp;Bernhard Frank,&nbsp;Ioannis N. Petropoulos,&nbsp;Marta Garcia-Finana,&nbsp;Timothy L. Jackson,&nbsp;Varo Kirthi,&nbsp;Daniel J. Cuthbertson,&nbsp;Dinesh Selvarajah,&nbsp;Solomon Tesfaye,&nbsp;Uazman Alam","doi":"10.1002/dmrr.3772","DOIUrl":"10.1002/dmrr.3772","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Diabetes mellitus (DM) is associated with structural grey matter alterations in the brain, including changes in the somatosensory and pain processing regions seen in association with diabetic peripheral neuropathy. In this case-controlled biobank study, we aimed to ascertain differences in grey and white matter anatomy in people with DM compared with non-diabetic controls (NDC).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study utilises the UK Biobank prospective, population-based, multicentre study of UK residents. Participants with diabetes and age/gender-matched controls without diabetes were selected in a three-to-one ratio. We excluded people with underlying neurological/neurodegenerative disease. Whole brain, cortical, and subcortical volumes (188 regions) were compared between participants with diabetes against NDC corrected for age, sex, and intracranial volume using univariate regression models, with adjustment for multiple comparisons. Diffusion tensor imaging analysis of fractional anisotropy (FA) was performed along the length of 50 white matter tracts.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We included 2404 eligible participants who underwent brain magnetic resonance imaging (NDC, &lt;i&gt;n&lt;/i&gt; = 1803 and DM, &lt;i&gt;n&lt;/i&gt; = 601). Participants with DM had a mean (±standard deviation) diagnostic duration of 18 ± 11 years, with adequate glycaemic control (HbA1&lt;sub&gt;C&lt;/sub&gt; 52 ± 13 mmol/mol), low prevalence of microvascular complications (diabetic retinopathy prevalence, 5.8%), comparable cognitive function to controls but greater self-reported pain. Univariate volumetric analyses revealed significant reductions in grey matter volume (whole brain, total, and subcortical grey matter), with mean percentage differences ranging from 2.2% to 7% in people with DM relative to NDC (all &lt;i&gt;p&lt;/i&gt; &lt; 0.0002). The subcortical (bilateral cerebellar cortex, brainstem, thalamus, central corpus callosum, putamen, and pallidum) and cortical regions linked to sensorimotor (bilateral superior frontal, middle frontal, precentral, and postcentral gyri) and visual functions (bilateral middle and superior occipital gyri), all had lower grey matter volumes in people with DM relative to NDC. People with DM had significantly reduced FA along the length of the thalamocortical radiations, thalamostriatal projections, and commissural fibres of the corpus callosum (all; &lt;i&gt;p&lt;/i&gt; &lt; 0·001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Interpretation&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This analysis suggests that anatomic differences in brain regions are present in ","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chrononutrition in type 2 diabetes mellitus and obesity: A narrative review","authors":"Ludovica Verde,&nbsp;Tonia Di Lorenzo,&nbsp;Silvia Savastano,&nbsp;Annamaria Colao,&nbsp;Luigi Barrea,&nbsp;Giovanna Muscogiuri","doi":"10.1002/dmrr.3778","DOIUrl":"10.1002/dmrr.3778","url":null,"abstract":"<p>Chrononutrition is a nutritional regimen that follows our biological clock, marked by the changes in metabolism that occur during the day. This regimen includes the distribution of energy, the regularity and frequency of meals, and the importance of these factors for metabolic health. A growing body of animal and human evidence indicates that the timing of food intake throughout the day can have a significant and beneficial impact on the metabolic health and well-being of individuals. In particular, both the timing and frequency of meals have been associated with obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease, and other chronic conditions. Today's busy lifestyle makes many people skip breakfast and eat late at night. Eating late at night has been shown to cause a circadian misalignment, with the latter having a negative impact on weight control and glucose metabolism. Additionally, some studies have found a relatively strong association between skipping breakfast and insulin resistance, and T2DM. Against the backdrop of escalating obesity and T2DM rates, coupled with the recognized influence of food timing on disease evolution and control, this review aimed to synthesize insights from epidemiological and intervention studies of the interplay of timing of food intake and macronutrient consumption, reporting their impact on obesity and T2DM.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chrononutrition in cardiometabolic diseases: Current evidence and future perspectives","authors":"Salvatore Carbone,&nbsp;Paolo Pozzilli","doi":"10.1002/dmrr.3779","DOIUrl":"10.1002/dmrr.3779","url":null,"abstract":"<p>Chrononutrition is the field of nutritional science that investigates the relationship between food intake, timing of food intake, and their effects and influence on circadian rhythms and overall health. By aligning eating patterns with body's internal clock, optimisation of metabolic processes, improvements of various aspects of health can be achieved. Cardiovascular (CV) and metabolic diseases remain the leading cause of morbidity and mortality worldwide. Notably, in the US alone, approximately half of all cardiometabolic deaths are attributed to modifiable dietary factors, suggesting that dietary changes could result in dramatic increases in lifespan and its related quality of life. Social media have also a great impact on chrononutrition and their role cannot be neglected. The impact of social media on chrononutrition can be multifaceted: information dissemination, influence on eating habits, digital detox challenges, cultural influence and social jet lag. This special issue will provide novel insights and clarifications on chrononutrition, but also on additional controversial topics. The articles we selected should promote future preclinical and clinical studies to ultimately identify the most appropriate approaches to reduce the unacceptable high burden of CV and metabolic diseases.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolically healthy obesity, transition from metabolic healthy to unhealthy status, and carotid atherosclerosis","authors":"Qin Huang,&nbsp;Zeyu Liu,&nbsp;Minping Wei,&nbsp;Jie Feng,&nbsp;Qing Huang,&nbsp;Yunhai Liu,&nbsp;Zunjing Liu,&nbsp;XiaoJun Li,&nbsp;Li Yin,&nbsp;Jian Xia","doi":"10.1002/dmrr.3766","DOIUrl":"10.1002/dmrr.3766","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Evidence of the effects of metabolically healthy obesity (MHO) on atherosclerosis is limited; the transition effects of metabolic health and obesity phenotypes have been ignored. We examined the association between metabolic health and the transition to atherosclerosis risk across body mass index (BMI) categories in a community population.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This cross-sectional study was based on a national representative survey that included 50,885 community participants aged ≥40 years. It was conducted from 01 December 2017 to 31 December 2020, in 13 urban and 13 rural regions across Hunan China. Metabolic health was defined as meeting less than three abnormalities in blood pressure, glucose, high-density lipoprotein cholesterol, triglycerides, or waist circumference. The participants were cross-classified at baseline based on their metabolic health and obesity. In addition, the relationship between atherosclerosis and transitions in metabolic health status based on 4733 participants from baseline to the second survey after 2 years was considered. The relationship between metabolic health status and the risk of transition to Carotid atherosclerosis (CA) was assessed using logistic regression and Cox proportional hazards regression analyses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this study, the mean age of the participants was 60.7 years (standard deviation [SD], 10.91), 53.0% were female, and 51.2% had CA. As compared with metabolically healthy normal weight (MHN), those with MHO phenotype (odd ratio [OR] 1.10, 95% confidence interval [CI] 1.02–1.21), metabolically unhealthy normal weight (OR 1.27, 95% CI 1.19–1.35), metabolically unhealthy overweight (OR 1.41, 95% CI 1.33–1.48), and metabolically unhealthy obese (OR 1.54, 95% CI 1.44–1.64) had higher risk for CA. However, during the follow-up of 2 years, almost 33% of the participants transitioned to a metabolically unhealthy status. As compared with stable healthy normal weight, transition from metabolically healthy to unhealthy status (hazard ratios [HR] 1.21, 95% [CI] 1.02–1.43) and stable metabolically unhealthy overweight or obesity (MUOO) (HR 1.32, 95% CI 1.17–1.48) were associated with higher risk of CA.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In the community population, obesity remains a risk factor for CA despite metabolic health. However, the risks were highest for metabolically unhealthy status across all BMI categories. A large proportion of metabolically healthy overweight or participants with ","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3766","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma-derived exosomal miRNA profiles associated with type 1 diabetes","authors":"Haipeng Pang,&nbsp;Wenqi Fan,&nbsp;Linhua Pi,&nbsp;Xiajie Shi,&nbsp;Zhen Wang,&nbsp;Shuoming Luo,&nbsp;Yang Xiao,&nbsp;Xia Li,&nbsp;Gan Huang,&nbsp;Zhiguo Xie,&nbsp;Zhiguang Zhou","doi":"10.1002/dmrr.3774","DOIUrl":"10.1002/dmrr.3774","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Recently, exosomal miRNAs have been shown to play important roles in multiple diseases, including type 1 diabetes (T1D). To assess the biomarker potential of exosomal miRNAs for T1D, we measured the expression profiles of plasma-derived exosomal miRNAs in T1D and explored their potential functions by bioinformatic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>In the discovery phase, exosome samples were isolated from plasma by size exclusion chromatography from 10 T1D patients and 10 sex- (<i>p</i> = 0.36), age- (<i>p</i> = 0.97), and body mass index-matched (<i>p</i> = 0.47) healthy control subjects. Exosomal miRNA expression profiles were measured using the Illumina NovaSeq 6000 platform. With verification by quantitative real-time PCR (qRT‒PCR), we used multiple bioinformatics approaches to explore the potential biological functions of the identified differentially expressed miRNAs. The diagnostic signature of exosomal miRNAs was evaluated by least absolute shrinkage and selection operator (LASSO) regression and evaluated based on the area under the receiver operating characteristic curve (AUC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 43 differentially expressed miRNAs, among which 34 were upregulated and 9 were downregulated, were identified in T1D. After correcting for multiple testing using false discovery rate, 11 identified exosomal miRNAs still showed statistical significance. Among the 5 selected miRNAs, 3 miRNAs (miR-103a-3p, miR-144-5p and miR-454-3p) were successfully validated by qRT‒PCR. The biological analysis-enriched terms included protein autophosphorylation and the Hedgehog signalling pathway. The highest AUC of exosomal miRNA was 0.889 under the LASSO model. The expression levels of 5 selected exosomal miRNAs were correlated with multiple clinical characteristics such as fasting C-peptide and postprandial C-peptide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results indicated that plasma-derived exosomal miRNAs could serve as promising diagnostic biomarkers of T1D.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3774","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of sodium-glucose co-transporter-2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation","authors":"Yun-Yu Chen,&nbsp;Hao-Chih Chang,&nbsp;Yenn-Jiang Lin,&nbsp;Kuo-Liong Chien,&nbsp;Yu-Cheng Hsieh,&nbsp;Fa-Po Chung,&nbsp;Ching-Heng Lin,&nbsp;Gregory Y. H. Lip,&nbsp;Shih-Ann Chen","doi":"10.1002/dmrr.3775","DOIUrl":"10.1002/dmrr.3775","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The effectiveness of sodium-glucose co-transporter-2 inhibitors (SGLT2i) on incident dementia in patients with diabetes and atrial fibrillation (AF) remains unknown. This study aimed to investigate the association between SGLT2i and the risk of incident dementia in diabetic patients with AF, and to explore the interactions with oral anticoagulants or dipeptidyl peptidase-4 inhibitors (DPP4i).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a cohort study using Taiwan's National Health Insurance Research Database. Patients with diabetes and AFwithout a prior history of established cardiovascular diseases, were identified. Using propensity score matching, 810 patients receiving SGLT2i were matched with 1620 patients not receiving SGLT2i. The primary outcome was incident dementia, and secondary outcomes included composite cardiovascular events and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After up to 5 years of follow-up, SGLT2i use was associated with a significantly lower risk of incident dementia (hazard: 0.71, 95% confidence interval: 0.51–0.98), particularly vascular dementia (HR: 0.44, 95% CI: 0.24–0.82). SGLT2i was related to reduced risks of AF-related hospitalisation (HR: 0.72, 95% CI: 0.56–0.93), stroke (HR: 0.75, 95% CI: 0.60–0.94), and all-cause death (HR: 0.33, 95% CI: 0.24–0.44). The protective effects were consistent irrespective of the concurrent use of non-vitamin K antagonist oral anticoagulants (NOACs) or DPP4i.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In diabetic patients with AF, SGLT2i was associated with reduced risks of incident dementia, AF-related hospitalisation, stroke, and all-cause death. The protective effects were independent of either concurrent use of NOACs or DPP4i.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Offloading and adherence through technological advancements: Modern approaches for better foot care in diabetes","authors":"Sicco A. Bus,&nbsp;Neil D. Reeves,&nbsp;David G. Armstrong,&nbsp;Bijan Najafi","doi":"10.1002/dmrr.3769","DOIUrl":"https://doi.org/10.1002/dmrr.3769","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This manuscript aims to provide a review and synthesis of contemporary advancements in footwear, sensor technology for remote monitoring, and digital health, with a focus on improving offloading and measuring and enhancing adherence to offloading in diabetic foot care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative literature review was conducted by sourcing peer-reviewed articles, clinical studies, and technological innovations. This paper includes a review of various strategies, from specifically designed footwear, smart insoles and boots to using digital health interventions, which aim to offload plantar pressure and help prevent and manage wounds more effectively by improving the adherence to such offloading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In-house specially made footwear, sensor technologies remotely measuring pressure and weight-bearing activity, exemplified for example, through applications like smart insoles and SmartBoot, and other digital health technologies, show promise in improving offloading and changing patient behaviour towards improving adherence to offloading and facilitating personalised care. This paper introduces the concept of gamification and emotive visual indicators as novel methods to enhance patient engagement. It further discusses the transformative role of digital health technologies in the modern era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The integration of technology with footwear and offloading devices offers unparallelled opportunities for improving diabetic foot disease management not only through better offloading but also through improved adherence to offloading. These advancements allow healthcare providers to personalise treatment plans more effectively, thereby promising a major improvement in patient outcomes in diabetic foot ulcer healing and prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3769","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of sodium–glucose cotransporter-2 inhibitors and the risk of retinal vascular occlusion: A real-world retrospective cohort study in Taiwan","authors":"Tzu-Yi Lin,&nbsp;Eugene Yu-Chuan Kang,&nbsp;Shih-Chieh Shao,&nbsp;Edward Chia-Cheng Lai,&nbsp;Nan-Kai Wang,&nbsp;Sunir J. Garg,&nbsp;Kuan-Jen Chen,&nbsp;Je-Ho Kang,&nbsp;Wei-Chi Wu,&nbsp;Chi-Chun Lai,&nbsp;Yih-Shiou Hwang","doi":"10.1002/dmrr.3773","DOIUrl":"https://doi.org/10.1002/dmrr.3773","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Sodium–glucose cotransporter-2 inhibitors (SGLT2is) are proposed to alleviate the development of inflammatory eye diseases. However, the association between SGLT2i and retinal vascular occlusion remains unclear. Therefore, this study aims to explore the effects of SGLT2i on the incidence of retinal vascular occlusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analysed electronic medical records data from the largest multi-institutional database in Taiwan. Individuals who initiated SGLT2is and dipeptidyl peptidase 4 inhibitors (DPP4is) between 2016 and 2019 were included in our analysis. To conduct a homogenous comparison, inverse probability of treatment weighting with propensity scoring was employed. The primary outcome was retinal vascular occlusion, and the secondary outcomes were retinal vascular occlusion-related complications (macular oedema, vitreous haemorrhage, and tractional retinal detachment) and conditions requiring vitreoretinal intervention (intravitreal injection, retinal laser therapy, and vitrectomy).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 12,074 SGLT2i users and 39,318 DPP4i users were included. The incidence rate of retinal vascular occlusion in the SGLT2i and DPP4i groups was 1.2 (95% confidence interval [CI], 0.9–1.4) and 1.6 (95% CI, 1.3–1.8) events per 1000 person-years, respectively, which yielded a subdistribution hazard ratio (SHR) of 0.74 (95% CI, 0.55–0.99). Similar risk reductions were observed in the retinal vascular occlusion-related complications (SHR, 0.76; 95% CI, 0.69–0.84) and conditions requiring vitreoretinal intervention (SHR, 0.84; 95% CI, 0.77–0.94).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this multi-institutional study in Taiwan, SGLT2i use was associated with a reduced risk of retinal vascular occlusion. Further prospective studies are required to ascertain this association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3773","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139700544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The transiency of metabolically healthy obesity: Metabolic decline and atherosclerotic risk","authors":"Saeid Mirzai,&nbsp;Ian J. Neeland,&nbsp;Carl J. Lavie","doi":"10.1002/dmrr.3765","DOIUrl":"https://doi.org/10.1002/dmrr.3765","url":null,"abstract":"&lt;p&gt;The concept of metabolically healthy obesity (MHO)—obesity in the absence of metabolic abnormalities such as hypertension, dyslipidemia, and hyperglycemia—has sparked intense debate.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Up to 40% of people with obesity exhibit an MHO phenotype, seemingly escaping obesity's expected cardiometabolic sequelae.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; But is this a real phenomenon with a persistent favourable prognosis, or does MHO reflect a transient phenotype bound to become metabolically unhealthy with associated cardiovascular disease (CVD) consequences?&lt;/p&gt;&lt;p&gt;In this issue of the journal, Huang et al. provide data to support the latter premise.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The authors present an analysis of 50,885 middle-aged and elderly Chinese adults that examined the association between weight/metabolic phenotypes and subclinical atherosclerosis. Based on cutoffs from Chinese guidelines, participants were stratified by body mass index (BMI) into normal weight, overweight, or obesity. Metabolic health status was defined as healthy (0–2 of 5 metabolic abnormalities) or unhealthy (≥3 of 5 abnormalities) using the International Diabetes Federation criteria. Outcomes studied included early (increased carotid intima-media thickness [CIMT]), intermediate (plaques), and late (stenosis &gt;50%) stage carotid atherosclerotic changes along with a composite of the three, termed carotid atherosclerosis.&lt;/p&gt;&lt;p&gt;Their key findings were that metabolically unhealthy groups, irrespective of BMI category, had significantly heightened odds for carotid atherosclerosis compared with their healthy counterparts with similar BMI. This affirms metabolic disorders as the primary drivers of vascular disease rather than obesity itself. Still, participants with MHO (4.7% of participants) showed 10% higher odds for carotid atherosclerosis than healthy normal weight individuals after adjustment (adjusted odds ratio 1.10, 95% confidence interval [CI] 1.02–1.21), driven primarily by higher odds of increased CIMT (Figure 1). These findings remained significant in men and younger (≤60 years) participants with MHO but not their counterparts. Most strikingly, 33.4% of baseline metabolically healthy participants who were living with overweight or obesity developed metabolic abnormalities within the 2-year follow-up. These ‘converters’ had a 21% higher risk of carotid atherosclerosis than those maintaining stable healthy status over time (adjusted hazard ratio 1.21, 95% CI 1.02–1.43) (Figure 1).&lt;/p&gt;&lt;p&gt;The authors are applauded for a sophisticated study benefiting from a large, well-characterised cohort across a spectrum of body weight and metabolic parameters. Repeated health surveys enabled the evaluation of transitions from health to disease, and the characterisation of multi-stage carotid changes helped time-course understanding. However, some limitations exist. The exclusively Chinese population may restrict generalisability, and cardiorespiratory fitness (CRF) measures wer","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"40 2","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.3765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}