Clinical Medicine Insights-Endocrinology and Diabetes最新文献

{"title":"Postprandial Glucose: A Variable in Continuum.","authors":"Shashank Joshi, Jothydev Kesavadev, Prasanna Kumar K M, Banshi Saboo, Adi Mehta, Arpandev Bhattacharyya, Aravind Sosale, Puthiyaveettil Khadar Jabbar, R Santosh, Vaishali Deshmukh, Nilakshi Deka, Shambo Samrat Samajdar","doi":"10.1177/11795514251370507","DOIUrl":"10.1177/11795514251370507","url":null,"abstract":"<p><p>The global rise in diabetes mellitus presents a major healthcare challenge due to its associated complications. Effective glycemic control, crucial for reducing diabetes-related morbidity and mortality, encompasses 3 key components: fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and glycated hemoglobin (HbA1c). While FPG and HbA1c are commonly used for evaluating glycemic control, PPG also significantly influences overall glucose management. Postprandial hyperglycemia, the early deviation in type 2 diabetes mellitus (T2DM), plays a dominant role in individuals with near-target HbA1c levels. Advances in continuous glucose monitoring (CGM) provide a more comprehensive understanding of PPG fluctuations, offering real-time data and reducing the limitations of traditional monitoring methods. CGM technology revolutionizes glycemic monitoring, enhancing the management of PPG and supporting better diabetes care. This review emphasizes the importance of monitoring and managing PPG throughout the postprandial state in individuals with diabetes. It further consolidates evidence highlighting the importance of viewing PPG as a continuum and the potential of CGM in improving PPG management.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251370507"},"PeriodicalIF":3.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201443","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":"Assessment of the IDF-DAR Fasting Risk Assessment Tool to Predict Type 1 Diabetes-Related Complications During Ramadan in a Real-World Setting.","authors":"Abdullah M Alguwaihes, Mohamed Hassanein, Naweed Alzaman, Mohammed E Al-Sofiani, Metib Alotaibi","doi":"10.1177/11795514251376888","DOIUrl":"10.1177/11795514251376888","url":null,"abstract":"<p><strong>Background: </strong>The International Diabetes Federation-Diabetes and Ramadan (IDF-DAR) Practical Guidelines 2021 provide a risk stratification tool to guide the assessment of people with diabetes before they observe Ramadan. Here we conducted a survey study to explore the predictability of the IDF-DAR 2021 guidelines, and the factors associated with breaking fast, in people with type 1 diabetes (PwT1D) during Ramadan.</p><p><strong>Methods: </strong>This cross-sectional study included adult PwT1D living in Saudi Arabia, aged 18 years and above, who observed Ramadan 2022. Between May and August 2022, a standardized online questionnaire was used to collect data regarding socio-demographics, medical history (including the modality of T1D management and other components of the IDF-DAR risk calculator), and Ramadan fasting experience.</p><p><strong>Results: </strong>The study included 963 PwT1D (257 males and 706 females, mean age 26.5 ± 8.4 years). Applying the IDF-DAR risk calculator revealed that the study respondents included 66% high-risk PwT1D, 34% moderate-risk PwT1D (34%), and no low-risk PwT1D. Compared to the moderate-risk group, the high-risk group had significantly more days during which fasting was broken, a higher prevalence of diabetes complications, and more frequent diabetes-related ER visits (<i>P</i> < .01). Attending a pre-Ramadan education session was associated with 47% lower odds of visiting the ER during Ramadan (odds ratio 0.53; 95% confidence interval 0.34-0.82; <i>P</i> = .005).</p><p><strong>Conclusion: </strong>The IDF-DAR 2021 risk calculator predicts the risk of acute diabetes complications and ER visits during Ramadan fasting. Pre-Ramadan education sessions are important and may reduce acute complications among PwT1D during Ramadan fasting.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251376888"},"PeriodicalIF":3.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150972","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":"Biochemical and Structural Response to Lenvatinib in Metastatic Parathyroid Carcinoma: Case Report.","authors":"Wilfredo A Rivera, María J Ramírez, Alejandro Román","doi":"10.1177/11795514251372695","DOIUrl":"10.1177/11795514251372695","url":null,"abstract":"<p><p>Parathyroid carcinoma (PC) is an exceptionally rare endocrine malignancy characterized by severe hypercalcemia and high recurrence rates. We present the case of a 34-year-old male with chronic kidney disease who developed pathological fractures and progressive pulmonary metastases secondary to PC. Genetic analysis revealed a pathogenic variant in the CDC73 gene, indicating a hereditary predisposition. Following surgical resection, the patient experienced early biochemical relapse. Initial management with bisphosphonates, denosumab, and cinacalcet achieved temporary control of hypercalcemia. Upon radiological progression, lenvatinib therapy was initiated, resulting in 9 months of biochemical control and stabilization of both local disease and pulmonary metastases. However, discontinuation of denosumab and cinacalcet due to limited access led to a relapse of severe hypercalcemia and disease progression, necessitating the cessation of lenvatinib and transition to palliative care. This case underscores the diagnostic and therapeutic challenges of PC, highlights the potential role of targeted therapies like lenvatinib in advanced disease, and emphasizes the critical importance of sustained access to essential treatments.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251372695"},"PeriodicalIF":3.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114339","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":"Concurrent Hyperparathyroidism and Wilson's Disease in a Patient With Methanol Toxicity: A Rare Case Report.","authors":"Fatemeh Mohammadzadeh, Alireza Fatemi, Yasmin Yazdooei, Alireza Norouzi","doi":"10.1177/11795514251376459","DOIUrl":"10.1177/11795514251376459","url":null,"abstract":"<p><strong>Background: </strong>Wilson's disease (WD) is a rare genetic disorder that impairs copper metabolism, leading to its deposition in various organs, including the liver, brain, and cornea. Endocrine disorders, particularly hyperparathyroidism, are uncommon in WD. Methanol toxicity, a medical emergency, is rarely associated with WD and hyperparathyroidism, making this case particularly unique. We report a rare instance of this complex triad.</p><p><strong>Case presentation: </strong>A 53-year-old male with untreated WD presented with nausea, vomiting, dizziness, and blurred vision after ingesting methanol. Clinical examination revealed optic neuropathy, consistent with methanol toxicity, despite normal fundoscopy. Laboratory investigations revealed significant hypercalcemia and elevated parathyroid hormone (PTH) levels, confirming hyperparathyroidism. Imaging, including a prior technetium-99m sestamibi scan, indicated hyperfunctioning parathyroid tissue. Dialysis was initiated for methanol toxicity, and metabolic acidosis was corrected.</p><p><strong>Conclusion: </strong>This case emphasizes the rare coexistence of WD, hyperparathyroidism, and methanol toxicity, presenting significant diagnostic and therapeutic challenges. The pathophysiological interactions between these conditions are not well understood and warrant further research to improve management strategies and clinical outcomes.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251376459"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087688","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":"Linking Estimated Glucose Disposal Rate to Major Adverse Cardio-Cerebrovascular Events in Populations With and Without Diabetes: A Systematic Review and Meta-Analysis.","authors":"Shayan Shojaei, Hanieh Radkhah, Alireza Azarboo, Pedram Soltani, Sadaf Esteki, Asma Mousavi","doi":"10.1177/11795514251372702","DOIUrl":"10.1177/11795514251372702","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) contributes significantly to major adverse cardio-cerebrovascular events (MACCE), with the estimated glucose disposal rate (eGDR) serving as a novel marker for assessing IR. This systematic review and meta-analysis investigate the association between eGDR and MACCE outcomes, aiming to clarify its predictive value across different diabetes statuses.</p><p><strong>Methods: </strong>We searched databases for studies examining the relationship between eGDR and MACCE, including myocardial infarction (MI), stroke, ischemic heart disease (IHD), cardiovascular disease (CVD), and all-cause mortality. We compared groups with the lowest versus highest eGDR. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random effect models. Subgroup analyses assessed eGDR efficacy by diabetes status.</p><p><strong>Results: </strong>Our search identified 16 studies with 198 626 participants. The group with the lowest eGDR had a significantly higher risk of MACCE compared to the group with the highest eGDR (HR = 2.21, 95% CI 1.17-4.18). Additionally, the group with the lowest eGDR had notably worse outcomes for all-cause mortality, MI, stroke, CVD, and IHD with HRs of 2.03 (95% CI 1.05-3.90), 1.82 (95% CI 1.30-2.55), 2.82 (95% CI 1.66-4.69), 2.95 (95% CI 1.99-4.37), and 7.97 (95% CI 2.57-24.73), respectively. Subgroup analyses revealed consistent results for CVD in both populations with diabetes and non-diabetes status, for stroke in the population with non-diabetes status, and for IHD in the population with diabetes.</p><p><strong>Conclusions: </strong>Lower eGDR, indicating higher IR, is linked with a significantly increased risk of MACCE. This parameter could enhance risk stratification models for predicting MACCE. Further studies are needed to evaluate the clinical role of eGDR in managing cardio-cerebrovascular risk across subgroups.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251372702"},"PeriodicalIF":3.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082099","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":"Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis.","authors":"Diar Zooravar, Shayan Shojaei, Asma Mousavi, Pedram Soltani, Bahareh Shateri Amiri, Hanieh Radkhah","doi":"10.1177/11795514251365301","DOIUrl":"10.1177/11795514251365301","url":null,"abstract":"<p><strong>Background: </strong>Emerging lipid-related biomarkers, including the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Atherogenic Index of Plasma (AIP), have demonstrated potential in predicting metabolic disorders such as diabetes mellitus (DM) and associated microvascular complications, particularly diabetic kidney disease (DKD) and diabetic retinopathy (DR).</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aims to evaluate the association between these biomarkers and microvascular complications in individuals with DM, as well as to assess their diagnostic performance.</p><p><strong>Data sources and methods: </strong>A systematic literature search was performed in PubMed, Scopus, Embase, and Web of Science following PRISMA guidelines. Eligible studies examined the relationship between VAI, LAP, and AIP and microvascular complications in DM. The meta-analysis synthesized data using pooled weighted mean differences (WMDs) and area under the receiver operating characteristic curve (AUC) values to evaluate the predictive utility of these biomarkers for DKD and DR.</p><p><strong>Results: </strong>A total of 23 studies were included. Patients with DKD had significantly higher levels of LAP (WMD: 12.67; 95% CI: 7.83-17.51; <i>P</i> < .01), AIP (WMD: 0.11; 95% CI: 0.03-0.19; <i>P</i> < .01), and VAI (WMD: 0.63; 95% CI: 0.38-0.89; <i>P</i> < .01) compared to those without DKD. Additionally, each 1-unit increase in LAP (OR: 1.005; 95% CI: 1.003-1.006; <i>P</i> < .01), AIP (OR: 1.08; 95% CI: 1.04-1.12; <i>P</i> < .01), and VAI (OR: 1.05; 95% CI: 1.03-1.07; <i>P</i> < .01) was associated with an elevated risk of DKD. In contrast, no significant associations were identified between these biomarkers and DR. The diagnostic performance of VAI, LAP, and AIP was limited for both DR and DKD, with low discriminatory power.</p><p><strong>Conclusion: </strong>VAI, LAP, and AIP are significant predictors of DKD in individuals with DM but exhibit limited relevance for the detection of DR. Although these biomarkers show potential in identifying DKD risk, their overall diagnostic accuracy for DKD and DR remains modest, underscoring the need for further studies to enhance their clinical applicability.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251365301"},"PeriodicalIF":3.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875891","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":"Kangbo Knife Cryoablation for the Treatment of Functional Adrenal Tumors.","authors":"Zhaoxia Zhang, Lizhi Niu, Chao Li, Wenjin Yi, Feng Tian, Wenjuan Yang, Ying Xing","doi":"10.1177/11795514251357146","DOIUrl":"10.1177/11795514251357146","url":null,"abstract":"<p><p>Aldosterone-producing adenomas and cortisol-secreting adenomas are among the most common functional tumors of the adrenal gland. Primary aldosteronism often leads to refractory hypertension and significantly increases the long-term risk of stroke and cardiovascular events. Autonomous cortisol-secreting adenomas are associated with various complications, including hypertension, hyperglycemia, osteoporosis, infections, and thrombosis. This report presented 2 cases of adrenal tumors: one case involving an aldosterone-producing adenoma and the other involving a cortisol-secreting adenoma. The endocrine functionality of these tumors was assessed using standardized endocrine function tests, including supine and standing aldosterone tests and dexamethasone suppression tests. Bilateral adrenal vein blood sampling (AVS) was performed to localize the lesion responsible for the conditions. Both patients underwent treatment with Kangbo knife cryoablation. No immediate adverse events, such as puncture site pain, hematoma, or pneumothorax, were observed following the procedure. The patient with cortisol-secreting adenoma developed a postoperative pulmonary infection and minor pulmonary thrombosis, which were successfully managed. Postoperatively, both patients achieved biochemical remission, with normalization of aldosterone and cortisol levels. Clinical symptoms, including hypertension, hypokalemia, and moon facies, were significantly improved. Currently, there are no published reports on the use of cryoablation for the treatment of adrenal cortisol-secreting adenomas. To our knowledge, this study presents the first documented cases of AVS-guided Kangbo knife cryoablation for the treatment of aldosterone-producing adenoma and autonomous cortisol-secreting adenoma. The favorable clinical and biochemical outcomes achieved in this study highlight the potential of Kangbo knife cryoablation as a safe and effective novel therapeutic approach for these functional adrenal tumors.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251357146"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733767","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":"Diabetes Mellitus, Preoperative Glycemic Control and Postoperative Outcomes: A Multi-Ethnic Asian Perspective.","authors":"Roderica Rui Ge Ng, Charlene Xian Wen Kwa, Yuhe Ke, Brenda Pei Yi Tan, Mengling Feng, Hairil Rizal Abdullah","doi":"10.1177/11795514251356572","DOIUrl":"10.1177/11795514251356572","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a critical risk factor associated with postoperative complications. Preoperative glycemic control, commonly assessed by glycated hemoglobin (HbA1c), may help stratify patients with DM. However, association between DM, HbA1c levels and perioperative outcomes in multi-ethnic Asian populations with distinct cardiometabolic profiles remains underexplored.</p><p><strong>Objectives: </strong>This study aimed to study the association between pre-existing DM, suboptimal glycemic control (HbA1c ≥ 7%), and postoperative complications in elective non-cardiac surgical patients, focusing on the role of HbA1c as a risk stratification tool.</p><p><strong>Methods: </strong>This secondary analysis included 688 patients from a prospective cohort at Singapore's largest tertiary hospital. Postoperative complication(s) were assessed using the Comprehensive Complication Index. Patients were categorized into 2 groups-DM (regardless of HbA1c) and no DM (HbA1c ≤ 6%). We used multivariable logistic regression to explore associations within the entire cohort and DM subgroup. The relationship between preoperative HbA1c levels and postoperative complication(s) was also explored.</p><p><strong>Results: </strong>The overall incidence of postoperative complication(s) was 20.78%. DM was independently associated with increased postoperative complication(s) (adjusted OR 2.57, 95% CI 1.20-5.50, <i>P</i> = .015). A trend toward a higher likelihood of postoperative complication(s) was observed in patients with DM and suboptimal glycemic control (adjusted OR 1.39, 95% CI 0.56-3.45, <i>P</i> = .482) though this did not reach statistical significance. A noteworthy U-shaped relationship was identified between preoperative HbA1c levels and postoperative complication(s), with increased complications at both low and high HbA1c levels.</p><p><strong>Conclusion: </strong>This study highlights a significant association between DM and increased postoperative complications. The observed U-shaped relationship between HbA1c levels and complications underscores the need for comprehensive risk assessment across the full glycemic spectrum. Routine HbA1c screening and tailored perioperative strategies in multi-ethnic Asian populations could enhance surgical outcomes, reduce healthcare costs, and support broader public health goals in DM management.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251356572"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733766","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":"Effectiveness of Using a Digital Ecosystem for Ambulatory Diabetes Care in Patients Diagnosed With Type 2 Diabetes Mellitus.","authors":"Ana Maria Gomez, Diana Cristina Henao, Oscar Mauricio Muñoz, Oscar David Lucero, David Cortes, Andrés Del Castillo Cuervo, Andrea Jácome, Carlos Pertuz, Claudia Patricia Rubio","doi":"10.1177/11795514251349342","DOIUrl":"10.1177/11795514251349342","url":null,"abstract":"<p><strong>Background: </strong>Evidence of efficacy and safety of digital ecosystems in Latin America is scarce, which has limited their implementation. The objective of this study is to evaluate the safety and efficacy of the use of a digital ecosystem (Zutrics) in people with Type 2 Diabetes (PwT2D) treated with insulin.</p><p><strong>Methods: </strong>Analytical observational prospective cohort study in PwT2D, treated with insulin and oral or injectable antidiabetics, with HbA1c >8%, and followed up with a digital ecosystem (Zutrics). HbA1c and derived time in range (TIRd 70-180 mg/dL) were evaluated at baseline and at 3-month follow-up. Additionally, hypoglycemia events were evaluated during the follow-up.</p><p><strong>Results: </strong>We analyzed 69 patients (age 62 ± 12.5 years, 56.6% female), 45.1% had chronic kidney disease (CKD) and 25.4% coronary artery disease. About 45.1% were on multiple dose insulin treatment. Median HbA1c levels decreased from a baseline value of 9.1% (interquartile range, IQR 7.5-11.4) to 7.0% (IQR 6.3-8.08) at 3-month follow-up (<i>P</i> = .044). The median of HbA1c changes over time was -1.3% (IQR -0.13, -4.2). The mean TIRd of 70 to 180 mg/dL increased from 74% at baseline to 76.1% at the end of follow-up. The TBRd of <70 mg/dL did not change significantly, going from 0.5% at baseline to 0.94% The incidence density of hypoglycemia episodes was 0.009 events/patient-day during the follow-up. About 95.6% of patients met the goal of TBRd <70 mg/dL less than 4.</p><p><strong>Conclusion: </strong>This study suggests that the use of a digital ecosystem in the follow-up of PwT2D allows better glycemic control without increasing the risk of hypoglycemia.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251349342"},"PeriodicalIF":2.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477212","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":"Acanthosis Nigricans as a Clinical Risk Marker for Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Adriana Sánchez-García, María Eugenia Penados-Ovalle, René Rodríguez-Gutiérrez, Fernando Díaz-González Colmeneros, José Gerardo González-González","doi":"10.1177/11795514251345047","DOIUrl":"10.1177/11795514251345047","url":null,"abstract":"<p><strong>Background: </strong>Despite the association of insulin resistance (IR) in the pathophysiology of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), few studies have evaluated the utility of acanthosis nigricans (AN) as a clinical predictor for this condition. Thus, we aimed to determine the role of AN as a risk factor and clinical predictor of MASLD.</p><p><strong>Methods: </strong>This cross-sectional study conducted a comprehensive clinical history and physical examination. The presence of acanthosis nigricans was assessed in the neck, elbows, axillae, and knuckles. Liver biochemical parameters were measured, hepatic fat was analyzed using the controlled attenuation parameter (CAP), while hepatic stiffness was evaluated in kilopascals (kPA) with the FibrosScan 530 Compact and Smart Exam software. Multiple analyses were performed to determine the relationship between acanthosis nigricans and MASLD.</p><p><strong>Results: </strong>We recruited 251 adult participants. The mean BMI was 29.9 ± 7.3 kg/m², including 40.2% of participants with obesity and 63.7% with AN. Transient elastography evaluation resulted in 65.7% and 6% participants with hepatic steatosis (S3, 48.6%) and fibrosis, respectively. A non-adjusted (OR 2.63, 95% CI 1.57-4.52) and adjusted model (OR 1.97, 95% CI 0.95-4.12) were determined for AN as a risk factor for liver steatosis. Furthermore, the presence of AN in knuckles resulted in an association to predict liver steatosis (OR 2.09, 95% CI 1.01-4.35), while a multivariate analysis indicated that AN predicts a higher steatosis grade (S2 OR = 6.58, CI 95% 1.18-36.53; S3 OR = 2.36, CI 95% 1.04-5.3).</p><p><strong>Conclusions: </strong>Acanthosis nigricans demonstrated to predict a higher steatosis grade in adults with overweight and obesity. Our study supports the clinical applicability of AN as a screening tool for MASLD to identify high-risk subjects in resource-limited settings. Additional studies are needed to define alternative diagnostic tools for the early identification of metabolic risk factors in populations with specific clinical or demographic characteristics.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251345047"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303178","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}