Journal of Diabetes and Metabolic Disorders最新文献

{"title":"Metabolic dysfunction-associated steatotic liver disease in individuals with type 2 diabetes mellitus and diabetic foot ulcers: prevalence and associated factors.","authors":"Hüseyin Karaaslan, Ensar Gazi Göçer, Ferit Doğan","doi":"10.1007/s40200-025-01757-8","DOIUrl":"10.1007/s40200-025-01757-8","url":null,"abstract":"<p><strong>Purpose: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent among individuals with overweight, obesity, and type 2 diabetes mellitus (T2DM). Diabetic foot ulcers (DFUs) represent a severe complication of T2DM, but the prevalence of MASLD in this specific population remains unexplored. This study investigated the potential influence of DFU on MASLD incidence in T2DM.</p><p><strong>Methods: </strong>This study included 100 individuals with T2DM and DFUs. MASLD was assessed via liver ultrasound. Demographic data, laboratory results, and body mass index (BMI) were recorded. Participants were stratified into three BMI categories (≤ 25, 25-30, and ≥ 30 kg/m²) for comparative analysis.</p><p><strong>Results: </strong>The overall MASLD frequency was 39%, with no significant difference between genders (42.3% in males vs. 35.4% in females; <i>p</i> = 0.480). Inividuals with MASLD exhibited significantly higher mean BMI (27.3 ± 3.4 vs. 25.6 ± 3.7 kg/m²; <i>p</i> < 0.001) and hyperlipemia prevalence (59 vs. 46%; <i>p</i> < 0.001). The distribution of BMI categories in the overall sample resulted in 40% normal weight, 44% overweight, and 16% obese of prevalence (<i>p</i> < 0.001). MASLD prevalence increased with BMI category: 15% (BMI ≤ 25 kg/m²), 50% (BMI 25-30 kg/m²), and 69% (BMI ≥ 30 kg/m²).</p><p><strong>Conclusions: </strong>This study offers novel insights into MASLD prevalence among individuals with T2DM and DFU, suggesting a potential association between lower BMI and reduced MASLD incidence. However, MASLD development is multifactorial. Further research is needed to investigate the lower BMI levels observed and elucidate the complex interplay of factors influencing MASLD development in this population.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"228"},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between circulating amino acids and hepatic steatosis indices in Iranian adults aged over 50: findings from the Bushehr elderly health (BEH) program.","authors":"Azadeh Zarinkolah, Neda Cheraghloo, Azin Soltani, Kazem Khalagi, Nekoo Panahi, Maryam Amini Shirkouhi, Fatemeh Bandarian, Mostafa Rezaei-Tavirani, Gita Shafiee, Afshin Ostovar, Niloufar Najjar, Noushin Fahimfar, Iraj Nabipour, Farideh Razi, Mohammad Reza Mohajeri-Tehrani, Bagher Larijani","doi":"10.1007/s40200-025-01733-2","DOIUrl":"10.1007/s40200-025-01733-2","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence highlights the role of amino acid metabolism in non-alcoholic fatty liver disease (NAFLD) pathogenesis; however, data remain limited in Middle Eastern population. This study aimed to investigate the association between circulating amino acid profiles and NAFLD screened by the Fatty Liver Index (FLI) and Framingham Steatosis Index (FSI) among Iranian population 50years and over.</p><p><strong>Methods: </strong>This cross-sectional study included 1642 participants aged ≥ 50years from Bushehr Elderly Health Program. Amino acid levels were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). FLI and FSI were calculated as surrogate markers for NAFLD. Logistic regression and principal component analysis (PCA) were employed to assess associations between individual and clustered amino acid patterns and NAFLD indices, adjusting for confounders such as age, sex, BMI, diabetes, lipid profile, and inflammation markers.</p><p><strong>Results: </strong>The study included 1642 people (mean age62.24 ± 8.18 years). Higher levels of branched-chain, amino acids leucine (FSI: OR = 1.0083;FLI: OR = 1.0102) and valine (FSI: OR = 1.0064) and aromatic amino acids, tyrosine (FSI: OR = 1.0101;FLI: OR = 1.0211), phenylalanine (FLI: OR = 1.0131), tryptophan (FLI: OR = 1.0072), along with alanine (FSI: OR = 1.0039;FLI: OR = 1.0034) and glutamic acid (FSI: OR = 1.0032;FLI: OR = 1.0085), were positively associated with increased FLI and FSI scores (FDR < 0.05). PCA revealed component1 (rich in alanine, glutamic acid, leucine, valine, and proline) was positively associated with increased FLI(OR = 1.073,<i>p</i> = 0.019). Conversely, component4 (threonine, serine) was inversely associated with FSI(OR = 0.860,<i>p</i> = 0.024).</p><p><strong>Conclusions: </strong>Elevated levels of branched-chain and aromatic amino acids, are associated with increased FLI and FSI, while glycine, serine, threonine, and citrulline may exert protective effects. These findings underscore the potential role of amino acid metabolism in NAFLD pathogenesis and opportunities for dietary or metabolic interventions.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01733-2.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"229"},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comfort matters: evaluating preferences for Non-Invasive diabetes testing over conventional blood tests.","authors":"Andrew Sastri Dhanoo, Felicia Hill-Briggs, Seamus Sreenan, Brian Noel Cockburn","doi":"10.1007/s40200-025-01727-0","DOIUrl":"10.1007/s40200-025-01727-0","url":null,"abstract":"<p><strong>Objective: </strong>Evaluating comfort during traditional Diabetes Mellitus (DM) testing through blood collection versus non-invasive methods among individuals with and without DM and identifying personal characteristics influencing distress.</p><p><strong>Methods: </strong>This cross-sectional, observational study included 232 participants whose comfort levels were assessed using ten Likert scale questions. Participants were evaluated during traditional diabetes screening involving blood drawings and non-invasive screening methods. Anthropometrics, demographics, medical history, and HbA1c were also recorded. Principal Component Analysis (PCA) was used to identify factors contributing to participant comfort during traditional and non-invasive diabetes testing.</p><p><strong>Results: </strong>Two factors accounted for 57.59% of the variation, χ2(<i>n</i> = 232) = 917.55 (<i>p</i> < 0.001). Six questions were assigned to the Medical Testing Comfort (MTC) factor with a Cronbach's alpha of 0.876. The MTC questions assessed comfort during the typical diabetes testing procedures available in most developing countries worldwide. Lower MTC scores indicate greater discomfort during conventional tests and a preference for non-invasives. Non-invasive testing was preferred by 84.1 ± 1.5% of all participants, while those without a previous DM diagnosis were three times less likely to choose conventional testing. All children and adults without previous blood test experience preferred non-invasives. Joint mobility measurements were the preferred non-invasive method (98.7 ± 0.5%), followed by skin photography (96.1 ± 0.3%).</p><p><strong>Conclusions: </strong>Our findings highlight the importance of patient comfort in diabetes care, emphasizing the preference for non-invasive testing to enhance detection and management. The MTC scale's findings suggest revising DM testing protocols may expand surveillance, enhance healthcare experiences and improve outcomes.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"230"},"PeriodicalIF":2.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin-like growth factor (IGF) and Insulin-like growth factor binding proteins (IGFBP) as predictors of type 2 diabetes risk in obese adults.","authors":"Priyanshi Maurya, Jun Yang, Allan Barnes, Lisa R Yanek, Lewis C Becker, Allen D Everett, Dhananjay Vaidya","doi":"10.1007/s40200-025-01753-y","DOIUrl":"10.1007/s40200-025-01753-y","url":null,"abstract":"<p><strong>Aims: </strong>Obesity predisposes to Type 2 Diabetes, however, not all obese persons progress to diabetes; thus, risk stratification among non-diabetes people with obesity is important. Insulin-like Growth Factor-1 and Insulin-like Growth Factor Binding Proteins modulate metabolism and may predict diabetes in high-risk adults. We aim to investigate whether their levels predict future diabetes risk in non-diabetes individuals with obesity.</p><p><strong>Methods: </strong>In this case-cohort analysis nested within the Johns Hopkins GeneSTAR study, 40 incident diabetes cases and 40 random cohort sample with a BMI ≥30 kg/m² at baseline (38% males, 50% African Americans, age range 22-69 years) were followed for incident diabetes for ≥10 years. Sampling-weighted logistic regression assessed the relationship between baseline IGF/IGFBP biomarkers measured by ELISA and diabetes risk.</p><p><strong>Results: </strong>Higher baseline levels of IGF1, IGFBP1, IGFBP2, IGFBP3, and IGFBP6 predicted decreased odds of developing diabetes over 10 years when adjusted for sex, race, baseline age, and follow-up time. This association remained statistically significant for IGFBP2, IGFBP3, and IGFBP6 after adjusting for fasting baseline glucose.</p><p><strong>Conclusions: </strong>IGF/IGFBP complex proteins may serve as early indicators for diabetes risk beyond fasting glucose levels. Future studies should investigate the functional role of the IGF/IGFBP system in obesity, glucose metabolism, and diabetes prevention.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01753-y.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"226"},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and implementation of a diagnostic and therapeutic care pathway for type 2 diabetes management in the hospital setting: preliminary findings from an Italian retrospective observational study.","authors":"Michela Conti, Donatella Armata, Francesca Rubino, Laura Cuttitta, Emanuele Amodio, Alfredo Caputo, Gabriele Giannola, Alessandra Puleo, Maurizio Renda","doi":"10.1007/s40200-025-01745-y","DOIUrl":"10.1007/s40200-025-01745-y","url":null,"abstract":"<p><strong>Purpose: </strong>The 2022-2023 Italian diabetes guidelines emphasize individualized therapy and structured discharge planning for hospitalized patients with type 2 diabetes mellitus (T2DM). Despite the associate risks, traditional T2DM treatment regimens often include sulfonylureas and insulin. This study evaluated the impact of the Diagnostic and Therapeutic Care Pathway (PDTA) - a guideline-based program prioritizing GLP-1 receptor agonists (GLP-1RA) and SGLT2 inhibitors (SGLT2i), along with structured outpatient follow-up - on glycemic control in non-critically ill hospitalized T2DM patients.</p><p><strong>Methods: </strong>This retrospective, observational study included patients with pre-existing or newly diagnosed T2DM hospitalized in non-critical care settings due to acute events. All patients were managed under the PDTA and followed at 1, 3, 6, and 12 months post-discharge. The primary endpoint was the change in HbA1c from hospitalization. Data on prescribed T2DM treatments and hospital readmissions were collected.</p><p><strong>Results: </strong>Among 110 patients (mean age 71.8 ± 10.1 years), 45% were hospitalized due to major adverse cardiovascular events (MACE) and 55% due to sepsis or respiratory failure. The mean HbA_1c at hospitalization was 8.7% (Interquartile Range [IQR] 7.7-9.1), which monotonically and significantly decreased to 6.6% (IQR 6.1-7.7) at 12 months (<i>p</i> < 0.001). The greatest decrease occurred between 6 and 12 months, coinciding with the predominant use of combined GLP-1RA and SGLT2i therapy. Insulin requirement declined over time, both in prevalence and dosage. The 12-month hospital readmission rate was 13.9%, with few cardiovascular-related events.</p><p><strong>Conclusion: </strong>PDTA implementation resulted in sustained improvements in glycemic control among T2DM patients, supporting the broader adoption of structured, guideline-based care models.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01745-y.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"225"},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zebrafish as an effective model for accelerating diabetes research from discovery to therapy.","authors":"Hedieh Sadat Shamsnia, Mohammad Ali Faramarzi, Amir Hossein Abdolghaffari, Somayeh Mojtabavi","doi":"10.1007/s40200-025-01760-z","DOIUrl":"10.1007/s40200-025-01760-z","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a global health crisis affecting over 422 million people, necessitating innovative research models. Zebrafish (<i>Danio rerio</i>) have emerged as a powerful tool due to their genetic tractability, physiological similarity to humans, and suitability for high-throughput studies.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science, focusing on studies involving zebrafish models of Type 1 and Type 2 diabetes. Included publications were evaluated based on their methodology (e.g., surgical, chemical, genetic, or dietary induction of diabetes), reproducibility, and relevance to diabetic pathophysiology and complications.</p><p><strong>Results: </strong>Zebrafish models effectively replicate core diabetic features, including hyperglycemia, insulin resistance, and β-cell dysfunction. Their transparent embryos and larvae facilitate real-time visualization of metabolic and vascular changes. Furthermore, zebrafish support the study of diabetes-related complications-such as retinopathy, nephropathy, neuropathy, and cardiomyopathy-through genetic modifications and pharmacological interventions. Studies have demonstrated the efficacy of antidiabetic drugs, including metformin and glimepiride, using these models.</p><p><strong>Conclusion: </strong>Despite challenges (e.g., physiological differences from mammals), zebrafish bridge mechanistic discovery and translational applications, accelerating diabetes research. Their cost-effectiveness, rapid development, and screening potential underscore their critical role in understanding diabetes and developing targeted therapies to address this global health burden.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"224"},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates and predictors of peripheral artery disease in patients with type 2 diabetes mellitus in Calabar, Nigeria: a multicentre cross-sectional comparative study.","authors":"Araga Aburu, Enang Ofem, Melanie Nwabueze, Oluwakorede Babatope, Bridget Onabe, Hilary Odo, Love Okafor, Thelma Bassey, Elizabeth Araga, Bassey Ekeng","doi":"10.1007/s40200-025-01722-5","DOIUrl":"10.1007/s40200-025-01722-5","url":null,"abstract":"<p><strong>Background: </strong>Peripheral arterial disease is a major macrovascular complication of diabetes mellitus. We aimed to determine the prevalence of peripheral artery disease among patients with type 2 diabetes mellitus in Calabar and its correlation with traditional risk factors such as hypertension, dyslipidaemia, age, smoking, glycaemic control and inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen.</p><p><strong>Materials and methods: </strong>This was a hospital-based multi-centre cross-sectional comparative study. A proportionate stratified sampling technique was used to determine the number of diabetics recruited from the diabetes centre of the University of Calabar Teaching Hospital, Nigerian Navy Reference Hospital and General Hospital Calabar. Peripheral artery disease was defined as ankle brachial index value of < 0.9 in at least one limb and was measured using a handheld Doppler (8 MHz Life Dop Summit device).</p><p><strong>Results: </strong>The prevalence of peripheral artery disease using ABI < 0.9 in this study was 37.5% in people living with type 2 diabetes and 8.0% in controls. A statistically significant relationship was observed between advanced age (<i>p</i> = 0.003), hypertension (<i>p</i> = 0.03), duration of diabetes (<i>p</i> < 0.001), glycaemic control (<i>p</i> < 0.001), fibrinogen (<i>p</i> < 0.001) as well as C-reactive protein (<i>p</i> < 0.001), and peripheral artery disease among people living with Type 2 diabetes. After multiple regression analysis, the predictors of peripheral artery disease in this study were duration of diabetes and elevated serum C-reactive protein. There was no significant association between smoking, obesity and lipid profiles with peripheral artery disease.</p><p><strong>Conclusion: </strong>There is a high prevalence of peripheral artery disease among Type 2 diabetics in our setting. Besides the traditional risk factors such as advancing age, hypertension and duration of diabetes, which are known to be associated with peripheral artery disease in diabetics, we identified fibrinogen and C-reactive protein as inflammatory markers which could enhance the early detection of peripheral artery disease in Type 2 diabetics.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"223"},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous subcutaneous octreotide infusion in congenital hyperinsulinism: practical application and insights in infancy and early childhood.","authors":"Mercedes J Burnside, Adam Stafford-Bell, Rachel Romans, Matthew Moller, Catherine S Choong, Mary B Abraham","doi":"10.1007/s40200-025-01709-2","DOIUrl":"10.1007/s40200-025-01709-2","url":null,"abstract":"<p><strong>Purpose: </strong>Octreotide is second-line treatment for patients with congenital hyperinsulinism (CHI) unresponsive to diazoxide. Short-acting octreotide is administered via subcutaneous (SC) injection or continuous infusion using a pump, but limited data exist on pump therapy. We present two cases of CHI managed with an octreotide infusion via pump with or without concurrent continuous glucose monitoring (CGM), providing practical guidance.</p><p><strong>Case presentation: </strong>Octreotide 500mcg/1ml ampoule was used. The starting dose was 5mcg/kg/day, with titration to optimize glycaemia, and delivered as a continuous basal rate using a pump. CGM was used by Patient 2.Patient 1: CHI due to a paternal <i>ABCC8</i> mutation was detected at 16 weeks of age, with diffuse uptake on 18F-DOPA PET. Unresponsive to diazoxide, SC octreotide injections commenced, transitioning to an infusion (13mcg/kg/day) with good response, and complete cessation of therapy at four years.Patient 2: Neonate with CHI due to Beckwith Wiedemann Syndrome developed side-effects from diazoxide and was commenced on SC octreotide injections. Effective at 30mcg/kg/day, he transitioned to an infusion at 4.5 months followed by long-acting octreotide at 12 months.Both patients tolerated the infusion with no adverse effects.</p><p><strong>Conclusion: </strong>This report highlights the practical use of octreotide infusion via pump. When combined with CGM, it allows for tailored dosing to meet individual needs while enhancing patient convenience.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"222"},"PeriodicalIF":2.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis comparing the cardiovascular effects of sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 agonists in type 2 diabetes.","authors":"Laibah Arshad Khan, Khudija Sadia, Rahma Naveed, Rehan Khalid, Rabail Faisal, Abdur Rafay Bilal, Ayeza Nawaz, Abdullah Safdar, Talha Saleh Bin Siddique, Saleh Saeed Ahmad, Muhammad Ubaid Hussain, Muhammad Talha Asghar, Wajdan Ahmad","doi":"10.1007/s40200-025-01741-2","DOIUrl":"10.1007/s40200-025-01741-2","url":null,"abstract":"<p><strong>Purpose: </strong>Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 agonists have been shown to improve cardiovascular health. This meta-analysis aims to directly compare their cardiovascular outcomes in type 2 diabetes patients (T2DM).</p><p><strong>Methodology: </strong>We searched Medline, Scopus, Cochrane, and Web of Science from inception to August 2025 for observational studies that compared SGLT2 inhibitors and GLP-1 agonists in type 2 diabetes patients and baseline cardiovascular diseases (CVD). The primary outcomes were Major Adverse Cardiovascular Events (MACE) and heart failure (HF), while the secondary outcomes included all-cause mortality, cardiovascular mortality, myocardial infarction (MI), and stroke. The pooled hazard ratio with 95% confidence interval (CI) was employed through a random-effects model, and a p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Nineteen studies comprising 1,893,359 patients (1,182,641; SGLT2 inhibitors,710,718; GLP-1 agonists). Compared to GLP-1 agonist, SGLT2 inhibitor use was associated with a significant 18% reduced risk of heart failure in T2DM patients, while a non significantly reduced risk of MACE, all-cause mortality, cardiovascular mortality, myocardial infarction, and stroke. In T2DM patients with pre-existing CVD, SGLT2 inhibitors showed a significant 14% reduced risk of heart failure, 10% reduced risk of myocardial infarction, and 7% borderline reduced risk of all-cause mortality compared to GLP-1 agonists. In T2DM patients without pre-existing CVD, SGLT2 inhibitors demonstrated a significant 17% reduced risk of heart failure, with a non-significant reduction in MACE, all-cause mortality, and myocardial infarction compared to GLP-1 agonists, and a non-significantly increased risk of cardiovascular mortality and stroke.</p><p><strong>Conclusion: </strong>Use of SGLT2 inhibitors was associated with a lower risk of HF in T2DM, along with a lower risk of HF, MI, and all-cause mortality with pre-existing CVD compared to GLP-1 agonists. However, high heterogeneity and a lack of RCTs warrant cautious clinical implications.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40200-025-01741-2.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"221"},"PeriodicalIF":2.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular interactions of diabetes medications with alzheimer's related targets by molecular docking.","authors":"Atiyeh Kolouei, Mohammad Barati","doi":"10.1007/s40200-025-01747-w","DOIUrl":"10.1007/s40200-025-01747-w","url":null,"abstract":"<p><p>Diabetes, a prevalent chronic disease known for its complications such as cardiovascular issues, eye damage, and neuropathy, has increasingly been linked to an elevated risk of Alzheimer's disease and cognitive impairment. Individuals with diabetes are approximately twice as likely to experience cognitive dysfunction compared to the general population. This heightened risk is potentially mediated by factors such as hypoglycemic episodes, which can negatively impact brain function, particularly the hippocampus, a key region for memory. Furthermore, shared molecular and cellular characteristics between diabetes and Alzheimer's, such as the role of insulin in amyloid plaque formation, suggest a direct link between insulin resistance in the brain and the development of Alzheimer's-related pathology. This study investigates the potential of two commonly prescribed diabetes medications, <i>Ertugliflozin</i> and <i>Sitagliptin</i>, to impact Alzheimer's disease-related factors. <i>Ertugliflozin</i>, an SGLT2 inhibitor, lowers blood glucose by increasing glucose excretion via the kidneys, while <i>Sitagliptin</i>, a DPP-4 inhibitor, enhances insulin secretion and reduces glucagon secretion by preventing the breakdown of incretin hormones. Molecular docking was performed to assess the interaction of these drugs with five key targets implicated in Alzheimer's disease: amyloid-β, β-secretase (BACE1), γ-secretase, and acetylcholinesterase (AChE). The aim was to determine whether <i>Ertugliflozin</i> and <i>Sitagliptin</i> exhibit inhibitory effects on these Alzheimer's-related targets, suggesting a potential dual role beyond their established glucose-regulating mechanisms in diabetes. In this study, <i>Metformin</i> was utilized as the positive control ligand. Docking analysis revealed that <i>Ertugliflozin</i> and <i>Sitagliptin</i> exhibited the highest molecular affinity for γ-secretase (PDB code: 6iyc), followed by favorable interactions with β-secretase (PDB code: 1fkn) and amyloid-β (PDB code: 1iyt). Notably, <i>Ertugliflozin</i> showed notable interactions with acetylcholinesterase (PDB code: 1eve), whereas <i>Sitagliptin</i> showed no significant interaction with acetylcholinesterase. These findings suggest that <i>Ertugliflozin</i> and <i>Sitagliptin</i>, commonly used for diabetes management, may also influence factors implicated in Alzheimer's disease. By potentially inhibiting these factors, the drugs could exhibit a dual action, benefiting both diabetes and Alzheimer's. Further in vivo and clinical studies are needed to confirm these observations.</p>","PeriodicalId":15635,"journal":{"name":"Journal of Diabetes and Metabolic Disorders","volume":"24 2","pages":"220"},"PeriodicalIF":2.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}