Journal of Diabetes Research最新文献

{"title":"Empagliflozin Use Is Associated With Lower Risk of All-Cause Mortality, Hospitalization for Heart Failure, and End-Stage Renal Disease Compared to DPP-4i in Nordic Type 2 Diabetes Patients: Results From the EMPRISE (Empagliflozin Comparative Effectiveness and Safety) Study.","authors":"Gisle Langslet, Thomas Nyström, Dorte Vistisen, Bendix Carstensen, Emilie Toresson Grip, Paula Casajust, Giorgi Tskhvarashvili, Fabian Hoti, Riho Klement, Kristina Karlsdotter, Mikko Tuovinen, Anne Pernille Ofstad, Maria Lajer, Christina Shay, Lisette Koeneman, Soulmaz Fazeli Farsani, Leo Niskanen, Sigrun Halvorsen","doi":"10.1155/2024/6142211","DOIUrl":"10.1155/2024/6142211","url":null,"abstract":"<p><p><b>Objective</b>: To evaluate the effectiveness of empagliflozin in reducing all-cause mortality (ACM), hospitalization for heart failure (HHF), myocardial infarction (MI), stroke, cardiovascular mortality (CVM), and end-stage renal disease (ESRD) in routine clinical practice in the Nordic countries of the Empagliflozin Comparative Effectiveness and Safety (EMPRISE) study. <b>Methods</b>: This noninterventional, multicountry cohort study used secondary data from four Nordic countries (Denmark, Sweden, Finland, and Norway). Propensity score (PS) matched (1:1) adults with type 2 diabetes (T2D) initiating empagliflozin (a sodium-glucose cotransporter-2 inhibitor) during 2014-2018 who were compared to those initiating a dipeptidyl peptidase-4 inhibitor (DPP-4i). Cox proportional hazards regression modelling was used to assess the risk for ACM, HHF, MI, stroke, CVM, and ESRD. Meta-analyses were conducted and hazard ratios (HRs) with 95% confidence intervals (CIs) from random-effects models were calculated. <b>Results</b>: A total of 43,695 pairs of PS-matched patients were identified. Patients initiating empagliflozin exhibited a 49% significantly lower risk of ACM (HR: 0.51, 95% CI 0.40-0.64) compared to DPP-4i. Additionally, empagliflozin was associated with a 36% significantly lower risk of HHF (HR: 0.64, 95% CI 0.46-0.89), a 52% significantly lower risk of CVM (HR: 0.48, 95% CI 0.37-0.63), and a 66% significantly lower risk of ESRD (HR: 0.34, 95% CI 0.15-0.77) compared to DPP-4i. No significant differences were observed in the risk of stroke and MI between patients initiating empagliflozin compared with those initiating a DPP-4i. Results were generally consistent for subgroups (with/without pre-existing CV disease or congestive heart failure) and in sensitivity analyses. <b>Conclusion</b>: Empagliflozin initiation was associated with a significantly reduced risk of ACM, HHF, CVM, and ESRD compared with initiation of DPP-4i in patients with T2D when examining routine clinical practice data from Nordic countries.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"6142211"},"PeriodicalIF":3.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467066","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":"Diabetic Neuropathy Is Related to Rhinencephalon Degeneration in Adults With Type 1 Diabetes.","authors":"Maciej Chudzinski, Katarzyna Karmelita-Katulska, Anna Duda-Sobczak, Tatiana Fijalkowska-Ratajczak, Jakub Kopec, Michal Michalak, Dorota Zozulinska-Ziolkiewicz, Aleksandra Araszkiewicz","doi":"10.1155/2024/6359972","DOIUrl":"10.1155/2024/6359972","url":null,"abstract":"<p><p><b>Aims:</b> We aimed to assess neurodegenerative changes in the rhinencephalon via magnetic resonance imaging (MRI) and relate it to olfactory function and diabetic peripheral neuropathy (DPN) in adults with type 1 diabetes (T1D). <b>Materials and Methods:</b> Individuals aged 18-65 with T1D duration over 10 years and control healthy subjects underwent olfactory assessment using Sniffin'Sticks and brain MRI to assess volumetric measurements of the olfactory bulbs and piriform cortex thickness. <b>Results:</b> 32 T1D (24 males) aged 43.5 years (IQR: 37.0-48), diabetes duration 24.5 years (IQR: 20.5-27.0), and A1C 7.95% (IQR: 7.4-8.4) were assessed. The control group consisted of 6 healthy adults (4 males) aged 41.0 years (IQR: 36.0-48.0). Significantly lower olfactory test results in TDI (threshold-differentiation-identification) (31.5 (IQR: 28.7-33.6) vs. 34.1 (IQR: 33.2-37.2), <i>p</i> = 0.02) were obtained in the T1D as compared to the controls. Summarized olfactory bulb (OB) volumes and thickness of the left pyriform cortex were significantly smaller in T1D than in controls (65.8 mm³ (IQR: 57.9-71.7) vs. 75.8 mm³ (IQR: 74.8-76.7); <i>p</i> = 0.0005 and 3.1 mm (IQR: 2.7-3.4) vs. 3.6 mm (IQR: 3.5-4.1); p =0.02). Patients with DPN had significantly smaller OB volumes than patients without DPN (58.1 mm³ (IQR: 54.0-70.9) vs. 69.8 mm³ (IQR: 65.0-72.2); <i>p</i> = 0.02). Tobacco smoking (<i>β</i>: -7.89; <i>p</i> = 0.013) and DPN (<i>β</i>:-7.02; <i>p</i> = 0.015) proved to be independent predictors of OB volume. <b>Conclusions:</b> In adults with a long history of T1D, olfactory function and structures are impaired. The presence of diabetic neuropathy and ongoing smoking addiction might be considered predictors of the degradation of rhinencephalon structures in people with T1D.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"6359972"},"PeriodicalIF":3.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813282","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":"Whole Exome Sequencing in Children With Type 1 Diabetes Before Age 6 Years Reveals Insights Into Disease Heterogeneity.","authors":"Andreia Fiúza Ribeiro, Ana Laura Fitas, Marcela Oliveira Pires, Paula Matoso, Dário Ligeiro, Daniel Sobral, Carlos Penha-Gonçalves, Jocelyne Demengeot, Íris Caramalho, Catarina Limbert","doi":"10.1155/2024/3076895","DOIUrl":"10.1155/2024/3076895","url":null,"abstract":"<p><p><b>Aims:</b> This study is aimed at comparing whole exome sequencing (WES) data with the clinical presentation in children with type 1 diabetes onset ≤ 5 years of age (EOT1D). <b>Methods:</b> WES was performed in 99 unrelated children with EOT1D with subsequent analysis to identify potentially deleterious rare variants in MODY genes. High-resolution HLA class II haplotyping, SNP genotyping, and T1D-genetic risk score (T1D-GRS) were also evaluated. <b>Results:</b> Eight of the ninety-nine EOT1D participants carried a potentially deleterious rare variant in a MODY gene. Rare variants affected five genes: <i>GCK</i> (<i>n</i> = 1), <i>HNF1B</i> (<i>n</i> = 2), <i>HNF4A</i> (<i>n</i> = 1), <i>PDX1</i> (<i>n</i> = 2), and <i>RFX6</i> (<i>n</i> = 2). At diagnosis, these children had a mean age of 3.0 years, a mean HbA1c of 10.5%, a detectable C-peptide in 5/8, and a positive islet autoantibody in 6/7. Children with MODY variants tend to exhibit a lower number of pancreatic autoantibodies and a lower fasting C-peptide compared to EOT1D without MODY rare variants. They also carried at least one high-risk DR3-DQ2 or DR4-DQ8 haplotype and exhibited a T1D-GRS similar to the other individuals in the EOT1D cohort, but higher than healthy controls. <b>Conclusions:</b> WES found potentially deleterious rare variants in MODY genes in 8.1% of EOT1D, occurring in the context of a T1D genetic background. Such genetic variants may contribute to disease precipitation by a <i>β</i>-cell dysfunction mechanism. This supports the concept of different endotypes of T1D, and WES at T1D onset may be a prerequisite for the implementation of precision therapies in children with autoimmune diabetes.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"3076895"},"PeriodicalIF":3.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372006","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":"Efficacy and Safety of Ertugliflozin Compared to Placebo in Patients With Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis.","authors":"A B M Kamrul-Hasan, Muhammad Shah Alam, Samir Kumar Talukder, Mohammad Abdul Hannan, Deep Dutta, Lakshmi Nagendra, Shahjada Selim","doi":"10.1155/2024/5553327","DOIUrl":"10.1155/2024/5553327","url":null,"abstract":"<p><p><b>Background:</b> No comprehensive meta-analysis has evaluated the efficacy and safety of ertugliflozin compared to a placebo in patients with Type 2 diabetes (T2D) until now. This meta-analysis fills this gap in knowledge. <b>Methods:</b> A systematic search was carried out in electronic databases to identify randomized controlled trials (RCTs) that included patients with T2D receiving ertugliflozin in the treatment group and placebo in the control group. The change in HbA1c from the baseline values was the primary outcome, whereas changes in plasma glucose and other metabolic parameters and adverse events (AEs), including hypoglycemia, were the secondary outcomes. <b>Results:</b> Seven RCTs involving 7283 subjects met the inclusion criteria. Ertugliflozin outperformed placebo in reducing HbA1c in both 5 mg (MD -0.62%, 95% CI [-0.80, -0.44], <i>p</i> < 0.00001, <i>I</i> ² = 91%) and 15 mg (MD -0.69%, 95% CI [-0.91, -0.47], <i>p</i> < 0.00001, <i>I</i> ² = 93%) doses. A higher proportion of patients achieved HbA1c < 7.0% with ertugliflozin than with placebo. Ertugliflozin was also superior to placebo in lowering fasting plasma glucose (FPG), body weight, and systolic and diastolic blood pressure (BP). Ertugliflozin and placebo had comparable AE profiles, including urinary tract infection (UTI) and hypoglycemia, except for the greater risk of genital mycotic infections (GMIs) with ertugliflozin. Ertugliflozin 5 and 15 mg have equivalent efficacy and safety profiles except for greater weight reduction with ertugliflozin 15 mg. <b>Conclusion:</b> Ertugliflozin has a good glycemic efficacy and a reassuring safety profile in managing T2D. <b>Trial Registration:</b> Registration number: CRD42023456450.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"5553327"},"PeriodicalIF":3.6,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361637","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":"Risk Stratification in Twin Pregnancies Complicated by GDM.","authors":"Anja Catic, Florian Heinzl, Christian Göbl, Gülen Yerlikaya-Schatten, Theresa Reischer","doi":"10.1155/2024/5203116","DOIUrl":"https://doi.org/10.1155/2024/5203116","url":null,"abstract":"<p><p><b>Aims:</b> This study was aimed at assessing the association of oral glucose tolerance test (OGTT) glucose threshold levels and the requirement of insulin therapy in twin pregnancies with gestational diabetes mellitus (GDM). <b>Methods:</b> In this post hoc analysis of a cohort study spanning 18 years, 446 patients with twin pregnancy and GDM (246 managed with lifestyle modification and 200 requiring pharmacotherapy) were included. We collected and evaluated maternal characteristics, as well as fasting, 1-h, and 2-h glucose concentrations from a standardized 75-g OGTT. The assessment methods included logistic regression analysis, positive and negative predictive values, area under the curve (AUC), and random forest analysis. <b>Results:</b> The fasting (<i>p</i> < 0.01, OR: 1.03 [95% CI 1.01-1.05]) and 1-h (<i>p</i> < 0.01; OR: 1.01 [95% CI 1.00-1.02]) glucose levels during the OGTT were significantly associated with the subsequent need for insulin therapy, with thresholds of 95 mg/dL for fasting glucose and 184 mg/dL for the 1-h OGTT. Additionally, indications for insulin therapy were marked by thresholds of 108 mg/dL at G0, 215 mg/dL at G60, and 86 mg/dL at G120. <b>Conclusion:</b> Identifying threshold values for insulin therapy and risk stratification in twin pregnancy are crucial for optimal patient management.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"5203116"},"PeriodicalIF":3.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347909","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":"Mitigation of Diabetes Mellitus Using <i>Euphorbia helioscopia</i> Leaf Ethanolic Extract by Modulating GCK, GLUT4, IGF, and G6P Expressions in Streptozotocin-Induced Diabetic Rats.","authors":"Ahmed Raza, Muhammad Naveed Mushtaq, Sadia Hassan, Ali Sharif, Bushra Akhtar, Muhammad Furqan Akhtar","doi":"10.1155/2024/5497320","DOIUrl":"10.1155/2024/5497320","url":null,"abstract":"<p><p>Diabetes mellitus is a metabolic disorder. Synthetic antidiabetics are the commonly used treatment options associated with complications. The objective of this study was to explore the antioxidative and antidiabetic potential of <i>Euphorbia helioscopia</i> whole plant ethanolic extract using in vitro and in vivo models. For that purpose, the antioxidative potential was explored by using 2,2-diphenyl-1-picrylhydrazyl analysis. In vitro antidiabetic potential of the extract was evaluated using amylase inhibitory analysis. In vivo antidiabetic activity of the extract was assessed in diabetic rats using streptozotocin/nicotinamide (60 mg/kg/120 mg/kg) as an inducing agent. Metformin was used as standard. The results indicated the presence of significant quantities of phenolic 82.18 ± 1.28 mgg^-1 gallic acid equivalent (GAE) and flavonoid 66.55±1.22 mgg^-1 quercetin equivalent (QE) contents in the extract. Quantitation of phytoconstituents exhibited the presence of sinapic acid, myricetin, and quercetin using HPLC analysis. The extract inhibited <i>α</i>-amylase by 84.71%, and an antiglycemic potential of 50.34% was assessed in the OGTT assay. Biochemical analysis demonstrated a reduction in urea, creatinine, cholesterol, low-density lipoprotein, and alkaline phosphatase (<i>p</i> < 0.001) as compared to diabetic control rats at the dose of 500 mg/kg. An upregulation in the expressions of glucokinase, glucose transporter 4, peroxisome proliferator-activated receptor <i>γ</i>, and insulin-like growth factor was observed in treated rats in contrast to G6P expression, which was downregulated upon treatment. In conclusion, this study provided evidence of the antioxidative and antidiabetic potential of <i>E. helioscopia</i> whole plant ethanolic extract through in vitro and in vivo analysis and emphasized its promising role as a natural alternative.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"5497320"},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347908","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":"Preoperative Intravitreal Conbercept Injection Reduced Both Angiogenic and Inflammatory Cytokines in Patients With Proliferative Diabetic Retinopathy.","authors":"Zijing Huang, Li Jia Chen, Dingguo Huang, Jingsheng Yi, Zhiying Chen, Peimin Lin, Yifan Wang, Jianlong Zheng, Weiqi Chen","doi":"10.1155/2024/2550367","DOIUrl":"10.1155/2024/2550367","url":null,"abstract":"<p><p><b>Aims:</b> To investigate the impact of intravitreal injection of conbercept, a recombinant fusion protein with decoy receptors for the vascular endothelial growth factor (VEGF) family, on intraocular concentrations of angiogenic and inflammatory mediators in patients with proliferative diabetic retinopathy (PDR), analyzed its potential impact on surgical outcomes. <b>Methods:</b> Forty eyes from 40 patients with PDR were included in this prospective study. Patients received intravitreal injection of conbercept followed by vitrectomy or phacovitrectomy in 1 week. Aqueous humor samples were collected before and 1 week after the conbercept injection. The concentrations of angiogenic and inflammatory cytokines and chemokines were measured by flow cytometry. Follow-up clinical data were collected and analyzed. <b>Results:</b> Intravitreal conbercept injection significantly decreased aqueous concentrations of VEGF (325.5 (baseline) versus 22.3 pg/mL (postinjection), <i>p</i> < 0.0001), PlGF (39.5 versus 24.5 pg/mL, <i>p</i> < 0.0001), and PDGF-A (54.1 versus 47.0 pg/mL, <i>p</i> = 0.0016), while no impact on bFGF levels. For inflammatory mediators, the concentration of TNF-<i>α</i> (0.79 versus 0.45 pg/mL, <i>p</i> = 0.0004) and IL-8 (180.6 versus 86 pg/mL, <i>p</i> < 0.0001) were decreased, while IL-6 (184.1 versus 333.7 pg/mL, <i>p</i> = 0.0003) and IL-10 (1.1 versus 1.5 pg/mL, <i>p</i> = 0.0032) were increased. No significant changes in IFN-<i>γ</i> or MCP-1 were detected. Three months after surgery, the mean best-corrected visual acuity improved from a baseline of 1.8 ± 0.1 logMAR to 0.7 ± 0.1 logMAR (<i>p</i> < 0.0001), with 36 eyes (90%) achieving an improvement of visual function. <b>Conclusions:</b> Intravitreal conbercept injection presents dual effects of antiangiogenesis and anti-inflammation and can be served as an adjuvant treatment to vitrectomy for PDR patients.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"2550367"},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288790","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":"Radix Astragali and Its Representative Extracts for Diabetic Nephropathy: Efficacy and Molecular Mechanism.","authors":"Hui-Zhong Xue, Yu Chen, Shi-Dong Wang, Yi-Meng Yang, Lu-Qi Cai, Jin-Xi Zhao, Wei-Jun Huang, Yong-Hua Xiao","doi":"10.1155/2024/5216113","DOIUrl":"10.1155/2024/5216113","url":null,"abstract":"<p><p>Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus (DM). Radix Astragali (RA), a frequently used Chinese herbal medicine in the Leguminosae family, <i>Astragalus</i> genus, with its extracts, has been proven to be effective in DN treatment both in clinical practice and experimental studies. RA and its extracts can reduce proteinuria and improve renal function. They can improve histopathology changes including thickening of the glomerular basement membrane, mesangial cell proliferation, and injury of endothelial cells, podocytes, and renal tubule cells. The mechanisms mainly benefited from antioxidative stress which involves Nrf2/ARE signaling and the PPAR<i>γ</i>-Klotho-FoxO1 axis; antiendoplasmic reticulum stress which involves PERK-ATF4-CHOP, PERK/eIF2<i>α</i>, and IRE1/XBP1 pathways; regulating autophagy which involves SIRT1/NF-<i>κ</i>B signaling and AMPK signaling; anti-inflammation which involves IL33/ST2 and NF-<i>κ</i>B signaling; and antifibrosis which involves TGF-<i>β</i>1/Smads, MAPK (ERK), p38/MAPK, JNK/MAPK, Wnt/<i>β</i>-catenin, and PI3K/AKT/mTOR signaling pathways. This review focuses on the clinical efficacy and the pharmacological mechanism of RA and its representative extracts on DN, and we further document the traditional uses of RA and probe into the TCM theoretical basis for its application in DN.</p>","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"2024 ","pages":"5216113"},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288791","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 Effect of Vitamin D Supplementation on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis of Clinical Trials.","authors":"Maryam Afraie,Pourya Bahrami,Parisa Kohnepoushi,Sorour Khateri,Lobat Majidi,Lotfollah Saed,Kamran Zamani,Hedyeh Mohammadi Baharm,Yousef Moradi,Farhad Moradpour","doi":"10.1155/2024/9960656","DOIUrl":"https://doi.org/10.1155/2024/9960656","url":null,"abstract":"Background and Aims: The purpose of this meta-analysis was to investigate the effect of vitamin D supplementation on hemoglobin A1C (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), and the total vitamin D level in patients with Type 2 diabetes (T2DM). Methods: A systematic search was conducted in databases such as PubMed (Medline), Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov using relevant keywords from January 1990 to January 2024. After screening and extracting data, a qualitative evaluation of articles was performed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Results: The findings revealed that vitamin D supplementation significantly decreased the mean HbA1C (SMD: -0.15; 95% CI: -0.29, -0.20; I square: 79.76%; p value < 0.001) and mean FBS (SMD: -0.28; 95% CI: -0.40, -0.15; I square: 70.13%; p value < 0.001), lowered SBP (SMD: -0.06; 95% CI: -0.16, -0.05; I square: 39.63%; p value = 0.23), and reduced LDL (SMD: -0.11; 95% CI: -0.28, -0.05; I square: 73.66%; p value < 0.001). Furthermore, vitamin D supplementation increased the average HDL (SMD: 0.13; 95% CI: 0.04, 0.29; I square: 79.33%; p value < 0.001) and vitamin D levels (SMD: 1.78; 95% CI: 1.53, 2.04; I square: 91.92%; p value < 0.001) in patients with T2DM. Subgroup analyses showed that weight gain, BMI, and duration of the disease could reduce the effect of vitamin D supplementation on diabetes control in affected patients. Conclusion: The results also indicated that taking vitamin D supplements in the amount of 50,000 IU had a significant effect on reducing the indicators related to diabetes control. Based on the combined evidence, the findings of this meta-analysis suggest that vitamin D supplementation can significantly improve glycemic control and reduce the risk of complications associated with T2DM, especially cardiovascular diseases (CVDs).","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"81 1","pages":"9960656"},"PeriodicalIF":4.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254575","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":"Evaluating Preferences of Hospitalized Diabetes Patients for Hospital-Wide Glycemic Control Programme: A Discrete Choice Experiment.","authors":"Jing Dai,Ting He,Xiaodie He,Huaying Li,Lintong Li,Jie Sun,Jie Pan,Cheng Ji","doi":"10.1155/2024/2552658","DOIUrl":"https://doi.org/10.1155/2024/2552658","url":null,"abstract":"Background: Effective glycemic control is crucial for hospitalized patients, leading to benefits such as shorter hospital stays and reduced postoperative infection rates. While previous studies have emphasized the effectiveness of multidisciplinary collaborative stewardship for hospital-wide hyperglycemia management, patient perspectives and preferences have not been adequately considered. Objective: To identify factors influencing treatment preferences of Chinese hospitalized diabetes patients using discrete choice experiments (DCEs) and provide practical insights for the construction of a hospital-wide glycemic control programme. Methods: A face-to-face survey was conducted among diabetes patients admitted to nonendocrine departments in a tertiary hospital in Nanjing, China. The attributes and levels were determined based on DCE principles, and a conditional logit model was used to quantify patients' preferences. Results: A total of 157 respondents were analyzed. Antihyperglycemic effectiveness, healthcare providers, treatment regimen, monitoring frequency, and adverse reactions were the five attributes that significantly influenced patient preference (p < 0.05). Notably, an 80% glycemic control rate (β = 2.009) and a multidisciplinary management team involving clinical pharmacists (β = 1.346) had the greatest impact. Negative effects were observed for hypoglycemia (β = -1.008), insulin pump use (β = -0.746), and frequent glucose monitoring (β = -0.523). Female patients exhibited higher concern for healthcare providers (β = 1.172) compared to males. Younger and shorter-course patients prioritized antihyperglycemic effectiveness (β = 3.330, β = 1.510), while older patients preferred multidisciplinary management (β = 1.186) and opposed increased monitoring frequency (β = -0.703). Patients with higher educational backgrounds showed greater acceptance of continuous glucose monitoring (β = 1.983), and those with higher annual income placed more emphasis on glycemic control rate. Conclusion: Treatment preferences of hospitalized diabetes patients are mainly influenced by antihyperglycemic effectiveness, adverse reactions, healthcare providers, and individual characteristics. Comprehensive consideration and an individualized therapy strategy should be given when constructing a hospital-wide glycemic control programme.","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"4 1","pages":"2552658"},"PeriodicalIF":4.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254625","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}