Journal of diabetes and its complications最新文献

{"title":"Diabetes mellitus therapy in the light of oxidative stress and cardiovascular complications","authors":"Alaa A.M. Osman,&nbsp;Adrienn Seres-Bokor,&nbsp;Eszter Ducza","doi":"10.1016/j.jdiacomp.2024.108941","DOIUrl":"10.1016/j.jdiacomp.2024.108941","url":null,"abstract":"<div><div>Type 2 diabetes is a chronic disease requiring comprehensive pharmacological and non-pharmacological interventions to slow its progression and prevent or delay its micro- and macrovascular complications. Oxidative stress contributes to the development and progression of type 2 diabetes as well as to the development of its complications through several mechanisms. Therefore, therapeutic targeting of oxidative stress could aid in managing this disease and its complications. In our study, we have collected information on the most frequently used antidiabetic drugs (metformin, glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors) in the EU and the USA based on their antioxidant effects.</div><div>Based on our results, we can conclude that the antioxidant effects of the investigated antidiabetics may contribute significantly to the management of the disease and its complications and may open new therapeutic perspectives in their prevention.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108941"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822275","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":"Bone mineral density and the risk of kidney disease in patients with type 1 diabetes","authors":"Sabina Chaudhary Hauge ,&nbsp;Henrik Øder Hjortkjær ,&nbsp;Frederik Persson ,&nbsp;Simone Theilade ,&nbsp;Morten Frost ,&nbsp;Niklas Rye Jørgensen ,&nbsp;Peter Rossing ,&nbsp;Ditte Hansen","doi":"10.1016/j.jdiacomp.2024.108927","DOIUrl":"10.1016/j.jdiacomp.2024.108927","url":null,"abstract":"<div><h3>Aim</h3><div>To explore the association between bone disorder and the risk for progression of diabetic kidney disease (DKD) in persons with type 1 diabetes mellitus (T1DM).</div></div><div><h3>Methods</h3><div>In this prospective cohort study the association between bone mineral density (BMD), bone-derived factors (sclerostin, Dickkopf-1, and osteoprotegerin (OPG)), and four outcomes were investigated: 1) progression of albuminuria; 2) decline in estimated glomerular filtration rate (eGFR) ≥30 %; 3) kidney failure (KF); and 4) a composite kidney outcome consisting of at least one of the outcomes.</div></div><div><h3>Results</h3><div>In 318 participants (median follow-up time 5.5 years) patients with osteoporosis (BMD with T-score &lt; −2.5) had increased risk of eGFR decline: hazard ratio (HR) 2.56 (95 % CI 1.06–6.19, <em>p</em> = 0.04), KF: HR 9.92 (95 % CI 1.16–84.95, <em>p</em> = 0.04), and the composite kidney outcome: HR 2.42 (95 % CI 1.18–4.96, <em>p</em> = 0.02). Patients with high OPG had increased risk of eGFR decline, KF, and the composite outcome, compared to patients with low OPG in unadjusted analysis. No bone-derived factor was associated with any outcome in adjusted analyses.</div></div><div><h3>Conclusions</h3><div>In patients with T1DM low BMD was associated with progression of DKD, suggesting an interaction between bone and kidney.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108927"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872027","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":"Identifying predictors of sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide 1 receptor agonist use in hospital among adults with diabetes","authors":"Ashley Raudanskis ,&nbsp;Shohinee Sarma ,&nbsp;Tor Biering-Sørensen ,&nbsp;Katarina Zorcic ,&nbsp;Fahad Razak ,&nbsp;Amol Verma ,&nbsp;Magnus Thorsten Jensen ,&nbsp;Bruce A. Perkins ,&nbsp;Michael Colacci ,&nbsp;Michael Fralick","doi":"10.1016/j.jdiacomp.2024.108945","DOIUrl":"10.1016/j.jdiacomp.2024.108945","url":null,"abstract":"<div><h3>Aims</h3><div>To identify factors associated with use of novel diabetes medications among patients hospitalized under general internal medicine.</div></div><div><h3>Methods</h3><div>We conducted a cohort study of patients with type 2 diabetes mellitus (T2DM) hospitalized in Ontario, Canada between 2015 and 2020. We evaluated the patient- and physician-level factors associated with sodium-glucose cotransporter 2 inhibitor (SGLT2) and glucagon-like peptide 1 receptor agonist (GLP1R) use using a multivariable logistic regression model.</div></div><div><h3>Results</h3><div>There were 253,152 hospitalizations and 68,126 involved patients who had T2DM. Prior to discharge, 3.7 % (<em>N</em> = 2490) of patients with T2DM received an SGLT2 and 0.2 % (<em>N</em> = 121) received a GLP1R. The strongest predictors for receiving a novel diabetes medication were hemoglobin A1C &gt; 9.0 % (Odds Ratio (OR) = 1.81, 95 % Confidence Interval (CI) 1.28, 2.60) and patients aged 40–60 compared with patients &lt;40 years old (OR = 1.81, 95 % CI 1.33, 2.68). The strongest predictors for not receiving a novel diabetes medication were dementia (OR = 0.47, 95 % CI 0.39, 0.56) and creatinine ≥200 μmol/L (OR = 0.11, 95 % CI 0.08, 0.15). Overall, 46.8 % of patients hospitalized with T2DM not receiving a novel diabetes medication would potentially benefit from an SGLT2 inhibitor.</div></div><div><h3>Conclusions</h3><div>Novel diabetes medications were rarely continued or initiated during hospitalization despite a high prevalence of cardiovascular disease, raising the concern for systematic under-utilization after discharge.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108945"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909753","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":"Nicotinamide n-methyltransferase inhibitor synergizes with sodium-glucose cotransporter 2 inhibitor to protect renal tubular epithelium in experimental models of type 2 diabetes mellitus","authors":"Yuling Yang ,&nbsp;Fengxia Li ,&nbsp;Yankun Li ,&nbsp;Xue Li ,&nbsp;Zhonghua Zhao ,&nbsp;Nong Zhang ,&nbsp;Hui Li","doi":"10.1016/j.jdiacomp.2025.108952","DOIUrl":"10.1016/j.jdiacomp.2025.108952","url":null,"abstract":"<div><h3>Aims</h3><div>We aim to explore the potential of nicotinamide <em>n</em>-methyltransferase (NNMT) as a sensitive marker of renal tubular injury and the possibility of an NNMT inhibitor to combine with sodium-glucose cotransporter 2 (SGLT2) inhibitor to protect proximal tubular epithelium in vivo and in vitro model of Type 2 diabetes mellitus (T2DM), respectively.</div></div><div><h3>Methods</h3><div>In vivo, immunohistochemical staining, Masson's trichrome staining and Sirius red staining were used to observe the changes of NNMT expression, renal tubular injury and interstitial fibrosis in renal tissue from the db/db mice. Bioinformatic analysis was also conducted to broaden the range of data validation. In vitro, Western Blot and quantitative RT-PCR were used to measure the degree of damage of HK-2 cells.</div></div><div><h3>Results</h3><div>Our in vivo data showed upregulation of NNMT expression paralleled renal tubular damage and interstitial fibrosis. Our in vitro data revealed both NNMT inhibitors and SGLT2 inhibitors can protect against the injury as assessed by extracellular matrix (ECM) synthesis and profibrotic phenotype transition of HK-2 cells, and the combination of these two agents can further reduce these injuries.</div></div><div><h3>Conclusions</h3><div>The present study is the first to show that NNMT is a promising marker of renal tubular injury in diabetic nephropathy (DN) and NNMT inhibitors can synergize with SGLT2 inhibitors to protect HK-2 better. Our findings will provide the insight and pave the way of developing novel therapeutic strategies for chronic renal tubular injury associated with T2DM.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108952"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028945","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":"Incidence of early-onset type 2 diabetes and sociodemographic predictors of complications: A nationwide registry study","authors":"Kristine Stoltenberg Addington ,&nbsp;Maria Kristiansen ,&nbsp;Nana F. Hempler ,&nbsp;Marie Frimodt-Møller ,&nbsp;Victor M. Montori ,&nbsp;Marleen Kunneman ,&nbsp;Stine H. Scheuer ,&nbsp;Lars J. Diaz ,&nbsp;Gregers S. Andersen","doi":"10.1016/j.jdiacomp.2024.108942","DOIUrl":"10.1016/j.jdiacomp.2024.108942","url":null,"abstract":"<div><h3>Aims</h3><div>Early-onset type 2 diabetes (T2DM) (18–45 years) is rising globally, yet complication incidence in this group remains unclear. We investigated the incidence of early-onset T2DM, the incidence of micro- and macrovascular complications, and how comorbidities (e.g., severe mental illness) and sociodemographic factors (e.g., education level) influence complication risk and timing in Denmark.</div></div><div><h3>Methods</h3><div>Using nationwide registers, we followed 8,129,005 individuals from 1996 to 2020 to estimate the incidence rate (IR) of early-onset T2DM. 49,850 individuals with early-onset T2DM were followed to calculate IRs for microvascular (nephropathy, retinopathy) and macrovascular (cardiovascular disease, amputation) complications. Incidence rate ratios (IRRs) assessed associations between comorbidities, sociodemographic factors, and complications. Poisson regression models calculated IRs and IRRs.</div></div><div><h3>Results</h3><div>From 1996 to 2020, the IR of early-onset T2DM more than doubled in men and tripled in women, with women dominating younger age groups. During follow-up (7.9–9.8 years), 37.6 % developed complications. Higher complication IRs were observed in men, those with sociodemographic disadvantages, and individuals with comorbidities. Early complications (≤5 years) were more common among the unemployed, single individuals, and those with comorbidities.</div></div><div><h3>Conclusions</h3><div>The rising IR of early-onset T2DM in younger women, and complications disproportionately affecting men and those with comorbidities or sociodemographic disadvantages, highlight the need for targeted interventions.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108942"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864014","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":"Artificial sweeteners and Type 2 Diabetes Mellitus: A review of current developments and future research directions","authors":"Francisca Obianuju Okoro,&nbsp;Victor Markus","doi":"10.1016/j.jdiacomp.2025.108954","DOIUrl":"10.1016/j.jdiacomp.2025.108954","url":null,"abstract":"<div><div>While artificial sweeteners are Generally Regarded as Safe (GRAS), the scientific community remains divided on their safety status. The previous assumption that artificial sweeteners are inert within the body is no longer valid. Artificial sweeteners, known for their high intense sweetness and low or zero calories, are extensively used today in food and beverage products as sugar substitutes and are sometimes recommended for weight management and Type 2 Diabetes Mellitus (T2DM) patients. The general omission of information about the concentration of artificial sweeteners on market product labels makes it challenging to determine the amounts of artificial sweeteners consumed by people. Despite regulatory authorization for their usage, such as from the United States Food and Drug Administration (FDA), concerns remain about their potential association with metabolic diseases, such as T2DM, which the artificial sweeteners were supposed to reduce. This review discusses the relationship between artificial sweetener consumption and the risk of developing T2DM. With the increasing number of recent scientific studies adding to the debate on this subject matter, we assessed recent literature and up-to-date evidence. Importantly, we highlight future research directions toward furthering knowledge in this field of study.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108954"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039320","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":"Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study","authors":"L. Rosien ,&nbsp;H.J.G. Bilo ,&nbsp;J. Oskam ,&nbsp;D. Ruwaard ,&nbsp;R.O.B. Gans ,&nbsp;M.A. Edens ,&nbsp;M.J. Molegraaf ,&nbsp;P.R. van Dijk","doi":"10.1016/j.jdiacomp.2025.108956","DOIUrl":"10.1016/j.jdiacomp.2025.108956","url":null,"abstract":"<div><h3>Background/objectives</h3><div>To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).</div></div><div><h3>Methods</h3><div>Retrospective, observational study using data from a database covering &gt;99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).</div></div><div><h3>Results</h3><div>Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).</div></div><div><h3>Conclusions</h3><div>Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.</div></div><div><h3>Level of evidence</h3><div>Level III retrospective cohort study.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 3","pages":"Article 108956"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098441","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":"The effect of semaglutide combined with metformin on liver inflammation and pancreatic beta-cell function in patients with type 2 diabetes and non-alcoholic fatty liver disease","authors":"Rong Ren ,&nbsp;Yanxia Pei ,&nbsp;Lufei Kong ,&nbsp;Yixin Shi","doi":"10.1016/j.jdiacomp.2024.108932","DOIUrl":"10.1016/j.jdiacomp.2024.108932","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) were often coexistent conditions driven by insulin resistance and systemic inflammation. Effective management strategies that address both metabolic disorders were urgently needed. This study investigates the effect of combining semaglutide, a glucagon-like peptide-1 receptor agonist, with metformin on liver inflammation and pancreatic beta-cell function in patients with T2DM and NAFLD.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 261 patients with T2DM and NAFLD treated at our institution from January 2021 to December 2023. Patients were divided into two groups: 127 received metformin alone (M group), and 134 received a combination of semaglutide and metformin (SAM group). Liver inflammation and fibrosis were assessed using alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GTP), and the FIB-4 index. Pancreatic beta-cell function and insulin sensitivity were evaluated using the Matsuda index, HbA1c, fasting glucose, and the oral disposition index (DIo).</div></div><div><h3>Results</h3><div>Post-treatment, the SAM group showed significantly greater improvements in liver inflammation markers (ALT: 23.59 ± 5.67 U/L in SAM vs. 25.56 ± 5.46 U/L in M; AST: 18.97 ± 3.94 U/L in SAM vs. 20.15 ± 3.95 U/L in M), reduced fibrosis (FIB-4 index: 1.05 ± 0.44 in SAM vs. 1.16 ± 0.51 in M), and enhanced beta-cell function (Matsuda index: 5.18 ± 1.09 in SAM vs. 4.84 ± 1.15 in M; DIo: 0.18 ± 0.06 in SAM vs. 0.16 ± 0.05 in M). Glycemic control, as indicated by reduced HbA1c, was also superior in the SAM group.</div></div><div><h3>Conclusion</h3><div>The combination of semaglutide and metformin significantly improves liver inflammation, fibrosis, and beta-cell function in patients with T2DM and NAFLD compared to metformin alone.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108932"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864355","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":"Comprehensive treatment with dapagliflozin in elderly chronic kidney disease patients: Clinical efficacy and impact on body composition","authors":"Kazuhiro Nomura ,&nbsp;Toshiyuki Takata ,&nbsp;Naokazu Muramae ,&nbsp;Hiroaki Takahashi ,&nbsp;Kozue Abe ,&nbsp;Tomokazu Matsuda","doi":"10.1016/j.jdiacomp.2025.108951","DOIUrl":"10.1016/j.jdiacomp.2025.108951","url":null,"abstract":"<div><h3>Background</h3><div>Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is widely used for treating heart failure and chronic kidney disease (CKD). While its renoprotective effects are well established, concerns remain regarding its impact on muscle mass and function, especially in elderly patients.</div></div><div><h3>Objective</h3><div>To assess the effects of dapagliflozin on renal function, body composition, and muscle strength in elderly CKD patients.</div></div><div><h3>Methods</h3><div>Twelve elderly CKD patients (75.6 ± 1.4 years) were treated with dapagliflozin for 12 months. Body composition, serum parameters, and muscle function were evaluated at baseline, 6 months, and 12 months. Measurements included changes in eGFR, liver function, HbA1c, and muscle strength.</div></div><div><h3>Results</h3><div>Dapagliflozin treatment stabilized eGFR without significant improvement, but proteinuria was notably reduced in most patients, indicating a positive renal effect. AST and ALT levels showed significant reduction after 12 months, suggesting improved liver function. No significant changes were observed in body weight, BMI, or muscle mass. Muscle function, as measured by the 5-sit-to-stand test, improved significantly, while grip strength remained stable. No serious adverse events were reported.</div></div><div><h3>Conclusion</h3><div>Dapagliflozin is a safe and effective treatment for CKD in elderly patients, demonstrating renal protection and improved liver function without adversely affecting muscle mass or strength. The study supports the use of dapagliflozin as part of a comprehensive approach, combining pharmacotherapy, lifestyle modification, and exercise to optimize patient outcomes in CKD management.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108951"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006492","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":"Association between muscle fatigability and diabetic kidney disease complications in patients with type 2 diabetes","authors":"Yuma Hirano ,&nbsp;Daisuke Tsuriya ,&nbsp;Kenichi Kono ,&nbsp;Tomoyuki Fujikura ,&nbsp;Tomoya Yamaguchi ,&nbsp;Kento Matsushita ,&nbsp;Yurina Yokoyama ,&nbsp;Katsuya Yamauchi ,&nbsp;Yusuke Nishida","doi":"10.1016/j.jdiacomp.2025.108955","DOIUrl":"10.1016/j.jdiacomp.2025.108955","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 diabetes mellitus (T2DM) requires the maintenance of high physical activity levels and specific interventions tailored to the characteristics of each patient. We hypothesized that T2DM combined with diabetic kidney disease (DKD) could increase muscle fatigability, becoming a specific contributor to physical inactivity. This study aimed to determine the association between muscle fatigability and DKD complications and investigate the relationship between muscle fatigability and physical activity in patients with T2DM.</div></div><div><h3>Methods</h3><div>Overall, 50 patients with T2DM aged 40–65 years and with an estimated glomerular filtration rate of 30 mL/min/1.73 m² or higher were included. Muscle function was assessed using an isokinetic dynamometer. Muscle fatigability (maximal voluntary concentric contraction [ΔMVCC] velocity, maximal voluntary isometric contraction [ΔMVIC] torque), which indicated the decrease in angular velocity and muscle strength associated with the exercise task, was calculated. The patient characteristics, physical activity (IPAQ-SV), knee extensor strength, and skeletal muscle index were evaluated. Participants were divided into two groups (DKD and non-DKD) according to the presence of DKD, and ΔMVCC velocity and ΔMVIC torque were compared.</div></div><div><h3>Results</h3><div>ΔMVCC velocity was significantly higher in the DKD group than in the non-DKD group (<em>p</em> &lt; 0.05). Similarly, ΔMVIC torque was significantly higher in the DKD group than in the non-DKD group (<em>p</em> &lt; 0.05). Subgroup analyses showed that ΔMVCC velocity was independently associated with physical activity in the DKD group (odds ratio: 0.93, 95 % confidence interval: 0.88–0.99).</div></div><div><h3>Conclusions</h3><div>Muscle fatigability increased with DKD in patients with T2DM and might be related to physical activity.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108955"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129414","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}