Journal of Diabetes最新文献

{"title":"Comprehensive Management of Diabetic Foot Ulcers: Current Evidence and Practice.","authors":"Ji Min Kim, Seon Mee Kang, Jung Hwa Jung, Ki Chun Kim, Sanghyun Ahn, Chong Hwa Kim, Tae Sun Park, Ie Byung Park","doi":"10.1111/1753-0407.70221","DOIUrl":"10.1111/1753-0407.70221","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFUs) represent one of the most severe and resource-demanding complications of diabetes mellitus, significantly contributing to morbidity through infections, lower-limb amputations, reduced quality of life, and elevated healthcare expenditures. The etiology of DFUs involves a multifaceted interplay among diabetic neuropathy, peripheral arterial disease, biomechanical abnormalities, and compromised tissue repair mechanisms. Despite advancements in diabetic care, DFUs continue to pose a substantial global health burden characterized by high recurrence rates and suboptimal long-term outcomes, particularly evident in regions such as China, where recurrence rates within 1 year exceed 30% among previously healed patients. Effective DFU management requires an integrated, multidisciplinary approach beginning with early risk stratification and accurate diagnosis, followed by targeted antimicrobial therapy, meticulous wound management, appropriate mechanical offloading, and comprehensive vascular assessment and intervention. This review synthesizes contemporary evidence and current clinical guidelines concerning DFU epidemiology, diagnostic criteria, and therapeutic strategies, underscoring the critical role of interdisciplinary coordinated care to enhance clinical outcomes and mitigate associated complications.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 4","pages":"e70221"},"PeriodicalIF":5.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758418","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":"Hydrogen-Enriched Hyaluronic Acid Dressing Ameliorates Diabetic Foot Ulcer via Promoting Mitophagy","authors":"Ziyu Xu,&nbsp;Xinyu Cui,&nbsp;Houbin Chu,&nbsp;Hao Wan,&nbsp;Yunbo Xie,&nbsp;Ying Wang,&nbsp;Qingbin Ni,&nbsp;Xiaolin Ding,&nbsp;Guohua Song","doi":"10.1111/1753-0407.70209","DOIUrl":"10.1111/1753-0407.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Diabetic foot ulcer (DFU) is one of the most common chronic complications of diabetes. This study developed a hydrogen-enriched hyaluronic acid (HA) dressing and aimed to explore its therapeutic effects and mechanisms in DFU treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A combination of vacuum-assisted closure (VSD) and hydrogen-rich saline was used to treat DFU patients and assess the clinical outcomes of wound repair. A rat model of DFU was established, and treatment with hydrogen-enriched HA dressing. Subsequently, the protective effects of the dressing were evaluated, including histological studies, the expression of inflammatory factors and angiogenesis markers. Western blot was used to analyze the expression levels of mitophagy-related proteins. In vitro, the role of HA and hydrogen on cell mitochondrial damage, apoptosis, migration, and markers associated with mitophagy pathways in human foreskin fibroblast-1 (HFF-1) was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>VSD combined with hydrogen-rich saline significantly enhanced wound healing in patients, while reducing inflammation and oxidative damage. In vivo studies showed that the dressing promoted wound healing, increased collagen deposition, reduced inflammatory cytokines, and enhanced neovascularization. In vitro studies, high glucose induced cell morphological damage and oxidative stress, disrupted mitochondrial membrane potential, leading to apoptosis and attenuating cell migration. However, both HA and hydrogen significantly induced SIRT3 expression and activated the downstream FOXO3A/PINK1-PARKIN signaling pathway, promoting mitochondrial autophagy and reducing cell apoptosis. Furthermore, the SIRT3/SOD2 pathway was also activated, decreasing reactive oxygen species (ROS) production and enhancing migration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study confirmed that the hydrogen-enriched HA dressing has the potential to enhance diabetic wound repair.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571413","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":"Advances in Research on Childhood-Obesity Associated With Gestational Diabetes Mellitus","authors":"Wantong Chen,&nbsp;Minghui Xi,&nbsp;Shuai Li,&nbsp;Luyi Li,&nbsp;Danhuai Zhang,&nbsp;Ming Gong,&nbsp;Yueyang Zhao,&nbsp;Na Wu","doi":"10.1111/1753-0407.70212","DOIUrl":"10.1111/1753-0407.70212","url":null,"abstract":"<p>Childhood obesity has emerged as a major global public health concern. Recent reports indicate that the worldwide obesity rate among children and adolescents has climbed to 8.5%. Obesity-related conditions present serious health risks. The causes of childhood obesity are multifactorial, with growing attention from researchers on the link between maternal gestational diabetes mellitus (GDM) and an elevated risk of obesity in offspring. This association can have lasting effects throughout childhood. Consequently, understanding the causes of childhood obesity and implementing effective preventive and therapeutic measures are crucial for managing and mitigating the condition and its associated health complications. This study aims to thoroughly explore the relationship between maternal GDM and the heightened risk of childhood obesity, examining developmental stages, underlying pathophysiological mechanisms, and contributing factors. By developing and applying targeted management strategies during a child's growth and development, the objective is to effectively curb and improve obesity outcomes among children born to mothers with GDM.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502620","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":"Neuroinflammation-Associated Optic Structural–Functional Degeneration in Early Diabetic Optic Neuropathy","authors":"Jingyuan Zhu,&nbsp;Jinyuan Wang,&nbsp;Haihan Zhang,&nbsp;Mingyang Wang","doi":"10.1111/1753-0407.70198","DOIUrl":"10.1111/1753-0407.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic optic neuropathy (DON) is characterized by optic nerve degenerative changes, which may progress to optic atrophy and even blindness. Although DON is relatively common, its early diagnosis remains challenging. This study employed a noninvasive in vivo imaging combined histopathological assessment system to investigate changes in optic structural–functional degeneration in DON models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Animals were divided into experimental group (8 db/db mice) and control group (8 db/m mice). Blood glucose, body weight, intraocular pressure, peripapillary retinal nerve fiber layer (RNFL), total retinal thickness (TRT), and visual behavior were at 2, 3, 4, 5 and 8 months old. Furthermore, histopathological and molecular validations were performed on the peripapillary retinal tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across the 6-month follow-ups, db/db mice remained hyperglycemic and obese. Compared with the control group, db/db mice showed significant thinning of the peripapillary RNFL and TRT, and pyroptosis of retinal gangolion cells at 3 months old, suggesting optic nerve degeneration. Meanwhile, decreased visual acuity and increased contrast sensitivity thresholds confirmed the establishment of an early DON model. Thinning of the TRT at 8 months old was found to be linearly correlated with decreased visual acuity, but not with contrast thresholds in the DON group. No significant differences of intraocular pressure were found between groups at any time point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Db/db mice provide a reliable model for early DON study. Retinal structural impairment was closely associated with visual dysfunction, underscoring the link between neurodegeneration and functional loss. These findings may facilitate early diagnosis and treatment of DON.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490223","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":"Effects of FTO Gene rs9939609 and rs17817449 Polymorphisms on Insulin Resistance in Turkish Children With Obesity","authors":"Merve Köksal,&nbsp;Mehtap Ünlü Söğüt,&nbsp;Sevtap Kabalı","doi":"10.1111/1753-0407.70213","DOIUrl":"10.1111/1753-0407.70213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>Fat mass and obesity-related gene (FTO) has been associated with glucose homeostasis and insulin sensitivity in some populations. The aim of this study was to evaluate the association of FTO gene rs9939609 and rs17817449 polymorphisms with insulin resistance, some cardiometabolic parameters, and body mass index (BMI) in Turkish children with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cross-sectional observational study included 83 children with obesity genotyped for variants of the FTO gene (rs9939609 and rs17817449). Children were divided into two groups as control and insulin resistant according to the homeostatic model assessment of insulin resistance (HOMA-IR). The relationship between the genotypes of rs9939609 and rs17817449 polymorphisms and insulin resistance was determined using binary logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the control group and insulin-resistant obese group, the majority of the rs9939609 polymorphism was AT (69.2%) and AA (64%) genotypes, and the majority of the rs17817449 polymorphism was GT (65.4%) and TT (70%) genotypes, respectively. Fasting glucose and insulin values were lower, and quantitative insulin sensitivity calculation index (QUICKI) values were higher in the risk genotype (GG) of rs17817449 polymorphism (<i>p</i> &lt; 0.05). Additionally, rs9939609 (AT genotype, OR = 0.063; 95% CI: 0.006–0.707, <i>p</i> = 0.025 and AA genotype, OR = 0.111; 95% CI: 0.021–0.576, <i>p</i> = 0.009) and rs17817449 (GT genotype, OR = 12.250; CI: 9.720–84.383, <i>p</i> &lt; 0.001) polymorphisms were strongly associated with insulin resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study supports that FTO gene rs9939609 and rs17817449 polymorphisms are associated with insulin resistance independently of age, gender, and BMI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483875","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":"Correlation of Thyroid Hormone Levels and Sensitivity With Metabolic Syndrome in Older Adults","authors":"Fengjuan Hu,&nbsp;Hu Liu,&nbsp;Linlin Gu,&nbsp;Shuli Jia,&nbsp;Lixing Zhou,&nbsp;Wanyu Zhao,&nbsp;Xiaolei Liu,&nbsp;Birong Dong","doi":"10.1111/1753-0407.70208","DOIUrl":"10.1111/1753-0407.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Previous studies have shown that thyroid function is associated with metabolic syndrome (MetS), but this association remains poorly understood in older adults. This study aimed to explore the relationships between thyroid hormone levels and sensitivity with MetS and its components in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2018 baseline data of the West China Health and Aging Trends study were used. MetS was diagnosed according to the International Diabetes Federation definition. Central thyroid hormone sensitivity was assessed by the TSH Index (TSHI), Thyrotrophic T4 Resistance Index (TT4RI), Thyroid Feedback Quantile-based Index (TFQI), and Parametric TFQI (PTFQI). Peripheral thyroid hormone sensitivity was assessed by the FT3 to FT4 ratio (FT3/FT4 ratio).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3796 participants were included. The prevalence of MetS was 40.31%. High FT3 levels and FT3/FT4 ratios were associated with abdominal obesity and hypertension; decreased FT3 levels were associated with hyperglycemia, hypertriglyceridemia and low HDL-C; low FT4 levels were associated with abdominal obesity and hypertriglyceridemia; increased TSH, TSHI and TT4RI levels were associated with hypertriglyceridemia and hypertension; and increased TFQI and PTFQI were associated with hypertension (<i>p</i> &lt; 0.05, for all). Increased FT3 (OR = 1.13, 95% CI: 1.05–1.22), TSH (OR = 1.12, 95% CI: 1.04–1.20), TSHI (OR = 1.09, 95% CI: 1.01–1.17), TT4RI (OR = 1.09, 95% CI: 1.01–1.16), FT3/FT4 (OR = 1.25, 95% CI: 1.16–1.35) and low FT4 (OR = 0.87, 95% CI: 0.81–0.94) were associated with MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Thyroid hormone levels are correlated with MetS and its components. Reduced central thyroid hormone sensitivity and increased peripheral thyroid hormone sensitivity are risk factors for MetS in older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483813","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":"Associations of Sarcopenia and Sarcopenic Obesity Using Different Obesity Definitions With Memory Decline","authors":"Ying Yue Huang,&nbsp;Wei Sen Zhang,&nbsp;Jiao Wang,&nbsp;Ya Li Jin,&nbsp;Kar Keung Cheng,&nbsp;Tai Hing Lam,&nbsp;Lin Xu","doi":"10.1111/1753-0407.70210","DOIUrl":"10.1111/1753-0407.70210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore the associations of sarcopenia and sarcopenic obesity (SO) with memory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Data from the Guangzhou Biobank Cohort Study (GBCS) were used to conduct both cross-sectional (<i>n</i> = 6390) and longitudinal (<i>n</i> = 3979) analyses. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019, while obesity was defined by 20 obesity indicators. Memory was assessed by the Delayed Word Recall Test (DWRT). Linear regression was used to analyze these associations. Two-sample Mendelian randomization (2SMR) was used to investigate potential causal associations of sarcopenia-related traits with memory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to participants without sarcopenia, those with sarcopenia had lower baseline and follow-up DWRT score, and greater decrease in mean annual change (MAC) and MAC rate of DWRT score, with adjusted βs (95% CIs) being −0.24 (−0.33 to −0.14), −0.10 (−0.20 to −0.004), −0.03 (−0.06 to −0.001) and −0.79 (−1.57 to −0.01), respectively. Among all the SO definitions, the associations of SO defined by waist-to-hip-to-height ratio (WHHR) appeared to be the strongest (−0.36 [−0.50 to −0.22], −0.31 [−0.45 to −0.17], −0.09 [−0.14 to −0.05] and −2.70 [−3.81 to −1.59]), and stronger than those with sarcopenia only or obesity only. In 2SMR, walking pace (one of the sarcopenia indicators) was positively associated with working memory (1.61 [0.59, 2.62]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sarcopenia and SO were associated with faster memory decline. Using the central obesity indicator WHHR to define SO may better predict late-life memory.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-0407.70210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442137","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":"Insights Into Macrophage Polarization and M1/M2 Balance in Diabetic Foot Ulcers","authors":"Jing Zhang,&nbsp;Hong Li,&nbsp;Yulin Dong,&nbsp;Zhuoyan Zhou,&nbsp;Yuhan Wang,&nbsp;Xia Chen,&nbsp;Yulan Cai","doi":"10.1111/1753-0407.70205","DOIUrl":"10.1111/1753-0407.70205","url":null,"abstract":"<p>Macrophage polarization, encompassing classically activated (M1) and alternatively activated (M2) states, is a critical determinant of immune response in wound healing. In diabetic foot ulcers (DFUs), a persistent imbalance favoring pro-inflammatory M1 over anti-inflammatory M2 macrophages drives chronic inflammation and impedes tissue repair. This review delineates the central role of macrophage polarization in DFU pathogenesis and systematically summarizes the key signaling pathways that govern this process, including PI3K/AKT, PPARγ, Notch, and Toll-like receptors (TLRs). We further synthesize these cascades into a novel hierarchical network model, identifying NF-κB and JAK–STAT as the core regulatory hubs. Beyond mechanism, we discuss emerging therapeutic strategies—including pharmacological agents and biomaterial-based approaches—that target macrophage polarization, positioning them as promising adjuvants to standard wound care. By integrating mechanistic insights with therapeutic potential, this review provides an updated framework for developing targeted immunomodulatory therapies to break the cycle of non-healing in DFUs.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429952","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":"Local Versus Systemic Antibiotics for Diabetic Foot Infection—A Systematic Review and Meta-Analysis","authors":"Anas Khan,&nbsp;Hester Lacey,&nbsp;Helena Michels,&nbsp;Mohamed Elahwal,&nbsp;Bjorn Telgenkamp","doi":"10.1111/1753-0407.70201","DOIUrl":"10.1111/1753-0407.70201","url":null,"abstract":"<p>Diabetic foot infection (DFI) includes soft tissue infection and osteomyelitis below the ankle and is a leading cause of lower limb amputation and mortality in diabetic patients. Treatment involves prolonged antibiotic therapy with surgical debridement or amputation. Local antimicrobial therapy offers an adjunct or alternative to systemic therapy. This systematic review and meta-analysis assessed the efficacy of systemic antibiotic therapy compared with local and combination (local and systemic) therapy in DFI. A meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A systematic search for studies was performed in eight sources (PROSPERO: CRD42024518421). The primary outcome was clinical cure rates, with secondary outcomes including clinical improvement, time to clinical cure, recurrence, amputation rates, and pathogen eradication. Twenty-one studies with 2188 participants met the inclusion criteria, including 12 randomized controlled trials and 9 observational studies. Combination antibiotics were associated with increased clinical cure rates compared with systemic antibiotics alone (OR 2.08; 95% CI 1.30–3.35; <i>p</i> &lt; 0.05) and faster healing times (Mean −9.8 days; 95% CI −15.1 to −4.4; <i>p</i> &lt; 0.05); however, results failed to reach significance when looking at randomized studies alone. Results for local antibiotics alone were non-significant for all outcomes. This meta-analysis suggests that definitive conclusions about the use of local antibiotics in DFI are limited by bias and heterogeneity within included studies. Combined local and systemic antibiotic treatment may allow for direct tissue infiltration of antimicrobial therapy. However, high-quality, blinded randomized controlled trials are required before routine clinical adoption.</p>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388922","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":"Nonlinear Association Between THs, TSH, and HbA1c in Patients With Type 2 Diabetes Mellitus: A Retrospective Study","authors":"Mengjie Chen,&nbsp;Yuqin Gan,&nbsp;Fengxiang Tian,&nbsp;Yun Bao,&nbsp;Zhonglan Chen","doi":"10.1111/1753-0407.70200","DOIUrl":"10.1111/1753-0407.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to investigate the potential non-linear relationships between thyroid hormones and thyroid-stimulating hormone levels on glycemic control levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of electronic medical records was performed on patients with T2DM who received treatment at a tertiary care hospital in Chengdu, Sichuan Province, between 2018 and 2023. RCS regression and threshold effect analyses were employed to assess potential nonlinear associations among THs, TSH, and glycemic control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from a total of 1413 patients were included in the analysis. RCS regression revealed a significant non-linear association between FT3 and HbA1c (<i>p</i> for nonlinearity &lt; 0.05). Threshold effect analysis demonstrated no statistically significant inflection point for FT3 in relation to HbA1c (FT3 &lt; 5.92 pmol/L, <i>β</i> = 0.008, 95% CI (−0.122, 0.281); FT3 &gt; 5.92 pmol/L, <i>β</i> = −0.109, 95% CI (−0.261, 0.042)). FT4 exhibited a significant non-linear relationship with HbA1c (<i>p</i> for nonlinearity &lt; 0.05), identifying an inflection point at 14.82 pmol/L. Below this threshold, each 1 pmol/L increase in FT4 was associated with a 0.263% elevation in HbA1c (<i>β</i> = 0.263, 95% CI 0.189–0.337). Similarly, TSH demonstrated a non-linear association with HbA1c (<i>p</i> for nonlinearity &lt; 0.05), with an inflection point identified at 5.53 mIU/L. When TSH was below 5.53 mIU/L, each 1 mIU/L increase was associated with a 0.179% reduction of HbA1c (<i>β</i> = −0.179, 95% CI −0.281 to −0.076).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nonlinear associations were observed between thyroid function markers (FT3, FT4, and TSH) and HbA1c levels in patients with T2DM. These findings provide novel evidence for understanding thyroid-glucose metabolic interactions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":189,"journal":{"name":"Journal of Diabetes","volume":"18 3","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388892","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}