Journal of Diabetes最新文献

{"title":"Glucokinase Regulatory Protein as a Putative Target for Gestational Diabetes Mellitus and Related Complications: Evidence From the Mendelian Randomization Study","authors":"Weian Mao,&nbsp;Guiquan Wang,&nbsp;Xiao Wang,&nbsp;Yan Shen,&nbsp;Shuai Yuan,&nbsp;Lin Wang,&nbsp;Haiyan Yang,&nbsp;Yan Li,&nbsp;Kai Chen,&nbsp;Jun Liu,&nbsp;Xi Dong,&nbsp;Yue Zhao,&nbsp;Liangshan Mu","doi":"10.1111/1753-0407.70056","DOIUrl":"https://doi.org/10.1111/1753-0407.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is highly associated with adverse perinatal outcomes and long-term health problems for the mother and offspring. However, there are respective limitations in the pharmacological strategies for the current treatment of GDM. Glucokinase regulatory protein (GCKR) has been associated with GDM in observational studies and animal experiments and thus represents a potential drug target of interest for investigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We applied two-sample Mendelian randomization (MR) and colocalization analysis using summary-level data from genome-wide association studies of GCKR and GDM. Two-step MR was used to explore the mediating effects of several metabolic factors on the association. We also applied MR to explore the associations of GCKR levels with GDM-related outcomes. Finally, we performed a phenome-wide association study (PheWAS) to query the potential effects of altered GCKR levels across multiple health categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found a significant association between elevated GCKR levels and GDM (OR = 3.466, 95% CI = 2.401–5.002, <i>p</i> = 3.16 × 10⁻¹¹), also supported by the colocalization analysis ([<i>P</i>_coloc] = 0.997). The estimates were replicated in an independent study (OR = 2.640, 95% CI = 1.983–3.513, <i>p</i> = 2.84 × 10⁻¹¹, <i>P</i>_coloc = 0.983). Elevated GCKR levels were also associated with higher risk of type 2 diabetes (OR = 2.183, 95% CI = 1.846–2.581, <i>p</i> = 6.53 × 10⁻²⁰). Two-step MR suggested that fasting glucose, fasting insulin, and triglycerides partly mediated the causal relationship. PheWAS found that targeting GCKR may improve renal function and glucose homeostasis but cause dyslipidemia and uric acid abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provided novel evidence that circulating GCKR levels are causally implicated in GDM and related complications, suggesting that it may be a promising target for treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362642","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":"Inverse Relationship Between Serum Carotenoid Levels and Cardiovascular-Kidney-Metabolic Syndrome Among the General Adult Population","authors":"Mengli Chen,&nbsp;Shuyue Cai,&nbsp;Qinfeng Jia,&nbsp;Yifang Suo,&nbsp;Yuan Tang,&nbsp;Yanping Shi,&nbsp;Xu Zhu,&nbsp;Haifeng Zhang","doi":"10.1111/1753-0407.70046","DOIUrl":"10.1111/1753-0407.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the relationship between serum carotenoid levels and cardiovascular-kidney-metabolic (CKM) syndrome in a representative sample of US adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the fasting subsample of the NHANES 2017–2018 were analyzed using a survey-weighted approach to ensure the findings are representative of the broader US adult population. Serum levels of α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and lycopene were measured using high-performance liquid chromatography. CKM syndrome stages were defined according to the 2023 American Heart Association guidelines, with advanced CKM syndrome categorized as stages 3 or 4. Associations between serum carotenoids and advanced CKM syndrome were assessed using logistic regression and weighted quantile sum (WQS) regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1671 adults aged 20 years and older, with a mean age of 48.7 years and a gender distribution of 50.9% female and 49.1% male. Higher serum levels of α-carotene, β-carotene, α-cryptoxanthin, lutein/zeaxanthin, and lycopene were inversely associated with advanced CKM syndrome. Specifically, compared to the lowest quartile, the highest quartile of α-carotene had an odds ratio (OR) of 0.29 (95% CI: 0.16–0.55), β-carotene 0.35 (95% CI: 0.16–0.78), α-cryptoxanthin 0.23 (95% CI: 0.11–0.49), lutein/zeaxanthin 0.26 (95% CI: 0.14–0.48), and lycopene 0.58 (95% CI: 0.35–0.98). However, β-cryptoxanthin did not show a significant association. Moreover, the combined effect of all carotenoids was significantly negatively correlated with advanced CKM syndrome (OR = 0.67, 95% CI: 0.53–0.86), with lutein/zeaxanthin contributing the most (44.56%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elevated serum carotenoid levels are inversely associated with the prevalence of advanced CKM syndrome in a dose-dependent manner, with this association remaining consistent across diverse demographic and health subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062629","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":"Age-Period-Cohort Analysis of Diabetes Incidence and Mortality in China and Globally, 1990–2019","authors":"Jinli Liu,&nbsp;Mingwang Shen,&nbsp;Guihua Zhuang,&nbsp;Lei Zhang","doi":"10.1111/1753-0407.70051","DOIUrl":"10.1111/1753-0407.70051","url":null,"abstract":"&lt;p&gt;Diabetes has rapidly emerged as a critical global health emergency of the 21st century [&lt;span&gt;1, 2&lt;/span&gt;]. China, bearing the highest global burden of diabetes, witnessed its prevalence rise from 10.6% in 2002 to 12.4% in 2018 [&lt;span&gt;3, 4&lt;/span&gt;]. Liu et al. [&lt;span&gt;5&lt;/span&gt;] reported a 0.89% annual increase in global diabetes incidence during 1990–2017. Diabetes mortality has remained stable in China, with an increase from 10.1/100 000 in 1990 to 10.3/100 000 in 2013 [&lt;span&gt;6&lt;/span&gt;]. Diabetes risk factors are diverse, including genetic, environmental, and metabolic elements [&lt;span&gt;7, 8&lt;/span&gt;], as well as family history [&lt;span&gt;7&lt;/span&gt;], socioeconomic development [&lt;span&gt;9&lt;/span&gt;], physical inactivity [&lt;span&gt;10&lt;/span&gt;], overweight and obesity [&lt;span&gt;11&lt;/span&gt;], and dietary changes [&lt;span&gt;12-15&lt;/span&gt;]. In recent years, these factors have evolved, shaping distinct temporal trends in diabetes-related diseases and influencing age, period, and cohort trends in diabetes incidence and mortality in both China and globally.&lt;/p&gt;&lt;p&gt;Previous studies have focused on the overall changes in the disease burden of diabetes over time [&lt;span&gt;16&lt;/span&gt;]. The present study aimed to explore the overall trends in diabetes incidence and mortality in China from 1990 to 2019, and then further analyze the age, period, and cohort-specific trends, comparing these with corresponding trends across the three dimensions at the global level. This study collected data from the Global Burden of Disease Study 2019, which includes only type 1 and type 2 diabetes among individuals aged 20 years and older. A log-linear model was used to analyze overall trends in diabetes incidence and mortality, followed by an age-period cohort model to examine age, period, and cohort trends in both China and globally, with comparisons made between the two populations.&lt;/p&gt;&lt;p&gt;The study highlighted similar age-related patterns in diabetes incidence risk in both China and globally, with an initial increase followed by a decline. However, the peak age for diabetes incidence risk in China was in the 50–54 age group, whereas in the global population, it occurred in the 55–59 age group (Figure 1a). China's peak age for diabetes incidence risk was approximately 5 years younger than the global peak age, consistent with previous findings [&lt;span&gt;17&lt;/span&gt;]. Before 2010, diabetes incidence risk in China was higher than the global average, but after 2010, it fell below the global average (Figure 1b). This suggests that diabetes prevention and control measures in China have been notably effective since 2010, highlighting the success of preventive policies [&lt;span&gt;18&lt;/span&gt;]. The diabetes incidence risk in individuals born in China between 1985 and 1999 has significantly increased compared to earlier cohorts and is also higher than that of the global population born in the same period (Figure 1c). This cohort likely experienced a sharp rise in diabetes risk due to China's rapid economic development and improved l","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062626","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":"Is Weight Loss the Main Driver for A1C Improvement by Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists? A 2.5-Year Analysis in Real-World Clinical Practice","authors":"Marwa Al-Badri,&nbsp;Shilton Dhaver,&nbsp;Osama Hamdy","doi":"10.1111/1753-0407.70054","DOIUrl":"10.1111/1753-0407.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are established treatment options for type 2 diabetes (T2D). In addition to their glycemic benefit, GLP-1 RAs also induce weight loss by suppressing appetite via hypothalamic pathways. However, it remains unclear whether weight reduction is the primary driver of glycemic improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively evaluated 256 patients with T2D who were treated with exenatide (<i>n</i> = 84), dulaglutide (<i>n</i> = 99), or semaglutide (<i>n</i> = 73) for 2.5 years without interruption in real-world clinical practice. Body weight and A1C were measured every 6 months. Baseline characteristics included an average age of 61.8 ± 11.9 years, 51.5% female, diabetes duration of 12.9 ± 8.3 years, weight of 103.1 ± 20.7 kg, BMI of 35.7 ± 7.5 kg/m², and A1C of 8.2% ± 1.5%. Patients were stratified into tertiles based on percentage weight change at 2.5 years within the overall cohort and for each GLP-1 RA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first tertile experienced an average weight loss of −12.2% ± 5.7% (<i>p</i> &lt; 0.0001), the second tertile lost −3.5% ± 1.4% (<i>p</i> &lt; 0.0001), and the third tertile gained +2.8% ± 3.4% (<i>p</i> &lt; 0.0001). The average changes in A1C were − 0.98 ± 1.8% (<i>p</i> &lt; 0.0001), −0.56% ± 1.4% (<i>p</i> &lt; 0.001), and −0.19% ± 1.9% (<i>p</i> = 0.4), respectively. A1C strongly correlated with weight change (<i>p</i> &lt; 0.001). The same observations were reproducible in each medication group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that the long-term improvement in glycemic control associated with GLP-1 RA therapy is primarily driven by weight loss rather than any other intrinsic effect of GLP-1 RA. This highlights the importance of weight reduction as a key therapeutic target for optimizing glycemic outcomes in patients with T2D receiving GLP-1 RAs.</p>\u0000 \u0000 <div>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031769","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":"“Path of the Heart” (The BPROAD Study) Addresses Optimal Systolic Blood Pressure for Patients With Diabetes","authors":"Ning Guang","doi":"10.1111/1753-0407.70053","DOIUrl":"10.1111/1753-0407.70053","url":null,"abstract":"&lt;p&gt;Awaiting my presentation at the centennial gathering of the American Heart Association (AHA) in Chicago, I opened my diary once again, particularly the one dated February 23, 2019, which reads, “After two years of meticulous preparation, the Path of the Heart research initiative has finally commenced.” The Path of the Heart refers to the BPROAD study, which has garnered significant acclaim due to its presentation at the Late-Breaking Science session of the AHA and concurrent publication in the prestigious &lt;i&gt;New England Journal of Medicine&lt;/i&gt; [&lt;span&gt;1&lt;/span&gt;]. Yet, few are acquainted with the trepidation that marked the inception of this endeavor 5 years prior, the indecision that lingered during the 2-year preparation phase, or the challenges posed by the COVID-19 pandemic throughout the study's execution. I extend my profound admiration and gratitude to the team led by Prof. Wang Weiqing, with Bi Yufang, Xu Yu, and Li Mian at the helm of the core research group, for their indomitable spirit and the resounding success of the study.&lt;/p&gt;&lt;p&gt;Hypertension affects 23.2% of the adult Chinese population, with a staggering half of diabetes patients also suffering from hypertension. Hypertension has emerged as the preeminent cause of mortality and disability among diabetes. Consequently, blood pressure management has become equally as imperative as glycemic control in the therapeutic strategies for diabetes in China. However, the optimal target for blood pressure reduction remains elusive. While the SPRINT study demonstrated a significant reduction in cardiovascular events with systolic blood pressure below 120 mmHg in hypertensive patients without diabetes [&lt;span&gt;2, 3&lt;/span&gt;], the ACCORD study failed to observe similar benefits in diabetes patients. Besides, the ACCORD study was a 2 × 2 factorial-design study examining both blood pressure and glucose control [&lt;span&gt;4&lt;/span&gt;]. Therefore, the target for blood pressure reduction in diabetes patients has become an unresolved issue, casting a shadow of confusion over clinical practice.&lt;/p&gt;&lt;p&gt;In light of this, the team led by Wang Weiqing and Bi Yufang from Ruijin Hospital has spearheaded the BPROAD study [&lt;span&gt;5, 6&lt;/span&gt;]. This nationwide, multicenter, open-label, parallel-group, randomized controlled clinical trial made its debut as the opening presentation at the 2024 AHA Scientific Session, marking a historic milestone for Chinese researchers in the field of cardiovascular and metabolic clinical research.&lt;/p&gt;&lt;p&gt;The BPROAD study has established that intensive blood pressure management targeting a systolic blood pressure below 120 mmHg, as opposed to conventional management aiming for below 140 mmHg, results in a 21% reduction in the primary composite endpoint of major cardiovascular events, including non-fatal stroke, non-fatal myocardial infarction, heart failure requiring treatment or hospitalization, and cardiovascular death, in type 2 diabetes patients with elevated systolic blood pressure and inc","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031757","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":"Linking Creatinine-to-Body Weight Ratio With Diabetes Incidence: A Multiethnic Malaysian Cohort Study","authors":"Noraidatulakma Abdullah,&nbsp;Ying-Xian Goh,&nbsp;Aisyatul Najihah Khuzaimi,&nbsp;Azwa Shawani Kamalul Arifin,&nbsp;Nurul Ain Mhd Yusuf,&nbsp;Nazihah Abd Jalal,&nbsp;Norliza Ismail,&nbsp;Nurul Faeizah Husin,&nbsp;Mohd Arman Kamaruddin,&nbsp;Rahman Jamal","doi":"10.1111/1753-0407.70039","DOIUrl":"10.1111/1753-0407.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging evidence suggests that the creatinine-to-body weight (Cre/BW) ratio is a predictor for incident diabetes in the Asian population. This study examined the association between Cre/BW ratio and incident diabetes, as well as the relationship between Cre/BW ratio and skeletal muscle and body fat mass in a multiethnic Malaysian cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 13 047 eligible participants were selected from 119 560 The Malaysian Cohort participants. Of these, 750 who developed diabetes were selected as cases, while 3750 controls were chosen randomly from healthy participants. This nested case–control study included 4500 eligible participants from The Malaysian Cohort, with a 1:5 case-to-control ratio. Participants were stratified into four groups based on Cre/BW ratio quartiles. The Cox proportional hazards model evaluated the effect of Cre/BW ratio on developing incident diabetes. The association between Cre/BW ratio and body composition was assessed using the Pearson correlation coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 13 047 eligible participants followed up over 5.3 years, 5.75% (<i>n</i> = 750) developed diabetes. Diabetes incidence decreased with increasing Cre/BW ratios. The Cre/BW ratio was inversely correlated with diabetes risk (HR: 0.403, 95% CI: 0.315–0.515, <i>p</i> &lt; 0.001). Additionally, males and Indians had a higher risk of developing incident diabetes. A significant correlation was observed between Cre/BW ratio and body fat mass (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study reveals an inverse association between the Cre/BW ratio and incident diabetes. It also found a significant moderate correlation between the Cre/BW ratio and body fat mass.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021353","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":"Overcoming Missing Data: Accurately Predicting Cardiovascular Risk in Type 2 Diabetes, A Systematic Review","authors":"Wenhui Ren,&nbsp;Keyu Fan,&nbsp;Zheng Liu,&nbsp;Yanqiu Wu,&nbsp;Haiyan An,&nbsp;Huixin Liu","doi":"10.1111/1753-0407.70049","DOIUrl":"10.1111/1753-0407.70049","url":null,"abstract":"<p>Understanding is limited regarding strategies for addressing missing value when developing and validating models to predict cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). This study aimed to investigate the presence of and approaches to missing data in these prediction models. The MEDLINE electronic database was systematically searched for English-language studies from inception to June 30, 2024. The percentages of missing values, missingness mechanisms, and missing data handling strategies in the included studies were extracted and summarized. This study included 51 articles published between 2001 and 2024, involving 19 studies that focused solely on prediction model development, and 16 and 16 studies that incorporated internal and external validation, respectively. Most articles reported missing data in the development (<i>n</i> = 40/51) and external validation (<i>n</i> = 12/16) stages. Furthermore, the missing data were addressed in 74.5% of development studies and 68.8% of validation studies. Imputation emerged as the predominant method employed for both development (27/40) and validation (7/12) purposes, followed by deletion (17/40 and 4/12, respectively). During the model development phase, the number of studies reported missing data increased from 9 out of 15 before 2016 to 31 out of 36 in 2016 and subsequent years. Although missing values have received much attention in CVD risk prediction models in patients with T2DM, most studies lack adequate reporting on the methodologies used for addressing the missing data. Enhancing the quality assurance of prediction models necessitates heightened clarity and the utilization of suitable methodologies to handle missing data effectively.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021357","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":"Brain Iron Deposition Alterations in Type 2 Diabetes Mellitus Patients With Mild Cognitive Impairment Based on Quantitative Susceptibility Mapping","authors":"Qiuyue Zhao,&nbsp;Subinuer Maimaitiaili,&nbsp;Yan Bi,&nbsp;Ming Li,&nbsp;Xin Li,&nbsp;Qian Li,&nbsp;Xinyi Shen,&nbsp;Min Wu,&nbsp;Linqing Fu,&nbsp;Zhengyang Zhu,&nbsp;Xin Zhang,&nbsp;Jiu Chen,&nbsp;Anning Hu,&nbsp;Zhou Zhang,&nbsp;Wen Zhang,&nbsp;Bing Zhang","doi":"10.1111/1753-0407.70052","DOIUrl":"10.1111/1753-0407.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Iron is one of the most important elements in brain that may has a direct impact on the stability of central nervous system. The current study devoted to explore the alterations of iron distribution across the whole brain in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The quantitative susceptibility mapping (QSM) technique was used to quantify the intracranial iron content of 74 T2DM patients with MCI and 86 T2DM patients with normal cognition (NC). The group comparison was performed by a voxel-based analysis. Then we evaluated the relationships between cognitive indicators and magnetic susceptibility value (MSV) measured by QSM of the significant brain areas, which were set as the regions of interest (ROIs). In addition, we analyzed the moderation effects of grey matter volume (GMV) of the related brain areas and several metabolic and cerebrovascular factors on the associations between MSV of ROIs and cognitive characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>T2DM patients with MCI exhibited a lower MSV in the right middle temporal gyrus (MTG) compared to NC group. And in the MCI group, there were significantly negative correlations between MSV of the right MTG and several memory indexes. Furthermore, the moderation effects of GMV of the whole brain and the bilateral MTG on the relationship between MSV of the right MTG and scores of list recognition were significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>T2DM patients with MCI had a temporary decreased iron content in the right MTG, which may partially compensate for cognitive impairment.</p>\u0000 \u0000 <p><b>Trial Registration:</b> The study was registered at Clinicaltrials.gov (NCT02738671)</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021393","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":"Commentary on “Protective Effect of Regular Physical Activity Against Diabetes-Related Lower Extremity Amputation”","authors":"Zeinab Mohseni Afshar,&nbsp;Mohammad Barary,&nbsp;Arefeh Babazadeh,&nbsp;Fatemeh Rasulpur,&nbsp;Soheil Ebrahimpour","doi":"10.1111/1753-0407.70055","DOIUrl":"10.1111/1753-0407.70055","url":null,"abstract":"&lt;p&gt;We read with great interest the article titled “Protective effect of regular physical activity against diabetes-related lower extremity amputation,” published in your esteemed journal [&lt;span&gt;1&lt;/span&gt;]. This study's objective—to evaluate the protective effects of appropriate and regular physical activity (PA) on the risk of lower extremity amputation (LEA) in individuals with diabetes—is both timely and relevant. We commend the authors for their valuable contributions to this critical area of research. However, certain study aspects warrant further discussion to enhance their scientific rigor and applicability.&lt;/p&gt;&lt;p&gt;First, the study did not incorporate specific laboratory parameters that could have strengthened its conclusions. Including biomarkers such as albumin, hemoglobin, thyroid and liver function tests, Vitamin D, Vitamin B12, Vitamin B3, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) would provide a more comprehensive understanding of the patients' risk profiles and the potential mechanisms linking PA to reduced LEA risk [&lt;span&gt;2&lt;/span&gt;]. For instance, NLR and PLR are well-established predictors of mortality and complications in diabetic foot ulcers and could offer additional prognostic value.&lt;/p&gt;&lt;p&gt;Second, the study lacked detailed information regarding medications other than antidiabetic agents. Drugs such as antihypertensives and lipid-lowering therapies can significantly impact vascular health and diabetic outcomes. Without this data, it is challenging to isolate PA's protective effects fully.&lt;/p&gt;&lt;p&gt;Third, while the study considered some comorbidities, a broader exploration of underlying conditions is necessary. Comorbidities such as malignancies, psychological disorders, cerebrovascular diseases, bone deformities, diabetic retinopathy, and autoimmune diseases—in addition to diabetic neuropathy and peripheral artery disease (PAD)—may influence both PA participation and LEA risk [&lt;span&gt;3&lt;/span&gt;]. Addressing these factors would provide a clearer understanding of the interactions between diabetes-related complications and PA.&lt;/p&gt;&lt;p&gt;Moreover, the study would benefit from additional demographic information, including educational level, urban versus rural residency, and history of previous diabetic ulcers. These variables are crucial as they can significantly influence diabetes management and adherence to PA regimens. Furthermore, there was no discussion regarding insulin resistance or the results of venous examinations, both pertinent to evaluating the risk of LEA.&lt;/p&gt;&lt;p&gt;In conclusion, while this study highlights the protective role of regular PA in preventing LEA among individuals with diabetes, addressing the limitations mentioned above would enhance its robustness and clinical relevance. Such considerations are critical for healthcare providers as they develop tailored strategies to improve patient outcomes. We hope the esteemed authors and editorial board will consider these constructive critiques and p","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021351","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":"Advancements and Challenges in Immune Protection Strategies for Islet Transplantation","authors":"Xue Wang,&nbsp;Ziyuan Zeng,&nbsp;Dayan Li,&nbsp;Kai Wang,&nbsp;Wei Zhang,&nbsp;Yang Yu,&nbsp;Xi Wang","doi":"10.1111/1753-0407.70048","DOIUrl":"10.1111/1753-0407.70048","url":null,"abstract":"<p>Pancreatic islet transplantation is a crucial treatment for managing type 1 diabetes (T1D) in clinical settings. However, the limited availability of human cadaveric islet donors and the need for ongoing administration of immunosuppressive agents post-transplantation hinder the widespread use of this treatment. Stem cell-derived islet organoids have emerged as an effective alternative to primary human islets. Nevertheless, implementing this cell replacement therapy still requires chronic immune suppression, which may result in life-long side effects. To address these challenges, innovations such as encapsulation devices, universal stem cells, and immunomodulatory strategies are being developed to mitigate immune rejection and prolong the function of the transplant. This review outlines the contemporary challenges in pancreatic β cell therapy, particularly immune rejection, and recent progress in immune-isolation devices, hypoimmunogenic stem cells, and immune regulation of transplants. A comprehensive evaluation of the advantages and limitations of these approaches will contribute to improved future clinical investigations. With these promising advancements, the application of pancreatic β cell therapy holds the potential to effectively treat T1D and benefit a larger population of T1D patients.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142996866","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}