Clinical Medicine Insights-Endocrinology and Diabetes最新文献

{"title":"The Expanding Role of GLP-1: From Diabetes Management to Cancer Treatment","authors":"Areeba Fareed, Aariz Hussain","doi":"10.1177/11795514231213566","DOIUrl":"https://doi.org/10.1177/11795514231213566","url":null,"abstract":"","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135611758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks to Reviewer's.","authors":"","doi":"10.1177/11795514231155766","DOIUrl":"https://doi.org/10.1177/11795514231155766","url":null,"abstract":"","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"16 ","pages":"11795514231155766"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/1f/10.1177_11795514231155766.PMC9943953.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10780713","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":"Value of 1-Hour Plasma Glucose During an Oral Glucose Tolerance Test in a Multiethnic Cohort of Obese Children and Adolescents.","authors":"Preneet Cheema Brar,&nbsp;Shilpa Mehta,&nbsp;Ajay Brar,&nbsp;Kristyn A Pierce,&nbsp;Alesandro Albano,&nbsp;Michael Bergman","doi":"10.1177/11795514231177206","DOIUrl":"https://doi.org/10.1177/11795514231177206","url":null,"abstract":"<p><p>One hour plasma glucose (1-hr PG) concentration during an oral glucose tolerance test (OGTT) is steadily emerging as an independent predictor of type 2 diabetes (T2D).</p><p><strong>Methods: </strong>We applied the current cut off thresholds reported in the pediatric literature for the 1-hr PG, 132.5 (7.4 mmol/l) and 155 mg/dL (8.6 mmol/l) during an OGTT, to report abnormal glucose tolerance (AGT) using ROC curve analyses. We determined the empirical optimal cut point for 1-hr PG for our multi ethnic cohort using the Youden Index.</p><p><strong>Results: </strong>About 1-hour and 2-hours plasma glucose showed the highest predictive potential based on Areas under the curve (AUC) values of 0.91 [CI: 0.85, 0.97] and 1 [CI: 1, 1], respectively. Further comparison of the ROC curves of the 1-hour and 2-hour PG measurements as predictors of an abnormal OGTT showed that their associated AUCs differed significantly (<i>X</i>²(1) = 9.25, <i>P</i> < .05). Using 132.5 mg/dL as the cutoff point for plasma glucose at 1-hour yielded a ROC curve with an AUC of 0.796, a sensitivity of 88%, and a specificity of 71.2%. Alternatively, the cutoff point of 155 mg/dL resulted in a ROC AUC of 0.852, a sensitivity of 80%, and a specificity of 90.4%.</p><p><strong>Conclusion: </strong>Our cross-sectional study affirms that the 1-hr PG can identify obese children and adolescents at increased risk for prediabetes and/or T2D with almost the same accuracy as a 2-hr PG. In our multi-ethnic cohort, a 1-hr PG ⩾ 155 mg/dL (8.6 mmol/l) serves as an optimal cut-point, using the estimation of the Youden index with AUC of 0.86 and sensitivity of 80%.We support the petition to consider the 1-hr PG as integral during an OGTT, as this adds value to the interpretation of the OGTT beyond the fasting and 2-hr PG.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"16 ","pages":"11795514231177206"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/e9/10.1177_11795514231177206.PMC10262663.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9646591","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":"Unilateral Phrenic Nerve Palsy as a Presentation of Diabetes Mellitus: A Rare Case Report.","authors":"Sruthi Chitrala,&nbsp;Nikhil Butta,&nbsp;Sandeep Kumar Immadisetty,&nbsp;Tarun Kumar Suvvari,&nbsp;Vimal Thomas","doi":"10.1177/11795514231189038","DOIUrl":"https://doi.org/10.1177/11795514231189038","url":null,"abstract":"<p><p>Diabetes mellitus is one of the most debilitating diseases, diabetic neuropathy happens to be the most common and perhaps the most serious complication of diabetes mellitus, often leading to morbidity and mortality. A 60 year old female presented with disorientation, history of vomiting, shortness of breath, respiratory failure initially. Blood reports revealed that she was positive for ketone bodies with elevated HbA1c and general random blood sugar. Chest radiogram revealed atelectasis of the right lung with prominent involvement of right middle and lower lobes. High-resolution computed tomography of chest confirmed the findings and unilateral diaphragmatic paralysis due to phrenic nerve neuropathy due to undetected type 2 diabetes was diagnosed. Although phrenic nerve paralysis is a rare occurrence with diabetes, the possibility shouldn't be overlooked as a presentation of diabetes mellitus.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"16 ","pages":"11795514231189038"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/3a/10.1177_11795514231189038.PMC10387670.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9926279","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":"Favorable Appendicular Skeletal Muscle Mass Changes in Older Patients With Type 2 Diabetes Receiving GLP-1 Receptor Agonist and Basal Insulin Co-Therapy.","authors":"Takafumi Osaka,&nbsp;Masahide Hamaguchi,&nbsp;Michiaki Fukui","doi":"10.1177/11795514231161885","DOIUrl":"https://doi.org/10.1177/11795514231161885","url":null,"abstract":"<p><strong>Background and aims: </strong>Maintaining appendicular skeletal muscle mass is important for maintaining the quality of life of elderly patients with type 2 diabetes. The possibility of GLP-1 receptor agonists for maintaining appendicular skeletal muscle mass has previously been reported. We investigated changes in appendicular skeletal muscle mass, measured by body impedance analysis, in elderly patients who were hospitalized for diabetes self-management education.</p><p><strong>Methods: </strong>The study design was a retrospective longitudinal analysis of the changes in appendicular skeletal muscle mass in hospitalized patients over the age of 70 years. The study subjects consisted of consequential patients who received GLP-1 receptor agonist and basal insulin co-therapy or received basal insulin therapy. Body impedance analysis was performed on the day after admission and on the ninth day of admission. All patients received standard diet therapy and standard group exercise therapy 3 times per week.</p><p><strong>Results: </strong>The study subjects consisted of 10 patients who received GLP-1 receptor agonist and basal insulin co-therapy (co-therapy group) and 10 patients who received basal insulin (insulin group). The mean change in appendicular skeletal muscle mass was 0.78 ± 0.7 kg in co-therapy group and -0.09 ± 0.8 kg in the insulin group.</p><p><strong>Conclusions: </strong>This retrospective observational study suggests the possibility of favorable effects of GLP-1 receptor agonist and basal insulin co-therapy for maintaining appendicular skeletal muscle mass during hospitalization for diabetes self-management education.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"16 ","pages":"11795514231161885"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/a5/10.1177_11795514231161885.PMC10070754.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9276730","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":"The Effectiveness of Insulin Pump Therapy Versus Multiple Daily Injections in Children With Type 1 Diabetes Mellitus in a Specialized Center in Riyadh.","authors":"Amir Babiker,&nbsp;Nawaf Alammari,&nbsp;Abdulrahman Aljuraisi,&nbsp;Rakan Alharbi,&nbsp;Hamoud Alqarni,&nbsp;Emad Masuadi,&nbsp;Haifa Alfaraidi","doi":"10.1177/11795514221128495","DOIUrl":"https://doi.org/10.1177/11795514221128495","url":null,"abstract":"<p><strong>Objectives: </strong>Comparison of continuous subcutaneous insulin infusion (CSII) with multiple daily injections (MDI) in achieving glycemic control in youths with type 1 diabetes mellitus (T1DM).</p><p><strong>Methods: </strong>Retrospective cohort study including 2 matched groups of youths with T1DM treated by CSII or MDI in a tertiary specialized children's hospital in Saudi Arabia. Children and adolescents aged up to 18 years, diagnosed with T1DM and using CSII or MDI, from the period 2016 to 2018. Patients on MDI were newly-diagnosed patients with T1DM who had the disease for only 1 year duration; all CSII patients had at least 1 to 2 years of T1DM but who had just started on pumps in the past 3 months. We excluded patients with other autoimmune diseases, non-ambulatory patients and those admitted to hospital for non-diabetes reasons. Primary outcome was HbA1c at 1, 2, and 3 years, with weight gain as a secondary outcome. Ambulatory glycemic profile was analyzed from a subset of patients using intermittently scanned continuous glucose monitoring (isCGM).</p><p><strong>Results: </strong>A total of 168 youths with T1DM (n = 129 in the MDI group, n = 39 in the CSII group) were included. The CSII group consistently had lower HbA1c levels compared to the MDI group throughout a 3-year follow up period: 8.1% versus 10.1, <i>P</i>-value < .001 at 1 year, 7.5% versus 10.1% at 2 years, <i>P</i>-value  < .001, 8.9% versus 10.3% at 3 years, <i>P</i>-value = .033. Body mass index significantly increased in both groups at 1 year, although greater in CSII group. In a subgroup using isCGM (n = 37 on MDI and n = 29 on CSII), the CSII group had a lower average blood glucose (194 mg/dL vs 228 mg/dL, <i>P</i>-value = .028) and a lower estimated HbA1c level (8.4% vs 9.6%, <i>P</i>-value = .022).</p><p><strong>Conclusion: </strong>Treatment with CSII resulted in lower HbA1c compared to MDI in our cohort, which was sustained over a 3-year period.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":" ","pages":"11795514221128495"},"PeriodicalIF":2.8,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/6a/10.1177_11795514221128495.PMC9597023.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40458570","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":"Nail Folds Capillaries Abnormalities Associated With Type 2 Diabetes Mellitus Progression and Correlation With Diabetic Retinopathy.","authors":"Dina M Abd El-Khalik,&nbsp;Eman A Hafez,&nbsp;Hanan E Hassan,&nbsp;Asmaa E Mahmoud,&nbsp;Doaa Maamoun Ashour,&nbsp;Nashwa A Morshedy","doi":"10.1177/11795514221122828","DOIUrl":"https://doi.org/10.1177/11795514221122828","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is an important microvascular consequence of long-term type 2 diabetes mellitus (T2DM), and it can lead to blindness if not properly diagnosed and managed. Nailfold video capillaroscopy (NVC) is a non-invasive technique for observing capillary microvasculature.</p><p><strong>Aim: </strong>We aimed to evaluate the nail folds capillaroscopic alterations in patients with T2DM by NVC and correlated the results to DR, and their relation to disease duration and hemoglobin A1c (HbA1c).</p><p><strong>Methods: </strong>This cross-sectional study enrolled 62 cases with T2DM (as per the American Diabetes Association criteria). All patients were subjected to NVC and ophthalmological assessment.</p><p><strong>Results: </strong>NVC revealed that Patients with DR showed significantly higher frequencies of tortuous capillaries, branched capillaries and precapillary edema versus non-DR patients with <i>P</i> < .05. The DR patients with longer disease duration (15-20) years had significantly higher frequencies of branched capillaries, tortuous capillaries, microhemorrhages, and dilated apical capillaries. The frequency of tortuosity and precapillary edema were significantly higher in patients with poor glycemic control. The increased capillary width and branched capillaries were detected as predictors of DR in multivariate analysis.</p><p><strong>Conclusion: </strong>NVC is a cost-effective, quick, safe, simple, non-invasive, and newly emerging tool to assess the capillaroscopic alterations in diabetic patients as an indicator of severity of DR.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"15 ","pages":"11795514221122828"},"PeriodicalIF":2.8,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/14/10.1177_11795514221122828.PMC9483964.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466931","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":"Association Between Lipophilic Beta-Blockers and Depression in Diabetic Patients on Chronic Dialysis.","authors":"Robin Lengton,&nbsp;Robbert W Schouten,&nbsp;Els Nadort,&nbsp;Elisabeth Fc van Rossum,&nbsp;Friedo W Dekker,&nbsp;Carl Eh Siegert,&nbsp;Ellen K Hoogeveen","doi":"10.1177/11795514221119446","DOIUrl":"https://doi.org/10.1177/11795514221119446","url":null,"abstract":"<p><strong>Background: </strong>Depression is associated with lower quality of life and increased risk of mortality. The prevalence of depression in chronic dialysis patients, as well as in patients with diabetes, is more than 20%. It is debated whether use of beta-blockers increases the risk of depression. Therefore, we examined in chronic dialysis patients with and without diabetes, the association between beta-blockers and depressive symptoms.</p><p><strong>Methods: </strong>Data were collected from the DIVERS-I study, a multicentre prospective cohort among chronic dialysis patients in the Netherlands. Depressive symptoms were assessed with the Beck Depression Inventory (BDI-II). We defined depressive symptoms as a BDI-II score ⩾16. The cross-sectional association at baseline between depressive symptoms and beta-blocker use in chronic dialysis patients, was studied by multivariable logistic regression adjusted for potential confounders.</p><p><strong>Results: </strong>We included 684 chronic dialysis patients, of whom 43% had diabetes mellitus, and 57% used a beta-blocker of which 97% were lipophilic. After multivariable adjustment, the OR (95% CI) for depressive symptoms in patients with compared to without diabetes was 1.41 (1.00-1.98), and in beta-blocker users compared to non-users 1.12 (0.80-1.56), respectively. Dialysis patients with diabetes and beta-blocker use compared to those without diabetes and not using beta-blockers had an OR of 1.73 (1.12-2.69) for depressive symptoms. The association was stronger in dialysis patients with diabetes and lipophilic beta-blocker use with an OR of 1.77 (1.14-2.74).</p><p><strong>Conclusions: </strong>We found a possible association between lipophilic beta-blocker use and depressive symptoms in chronic dialysis patients with diabetes.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":" ","pages":"11795514221119446"},"PeriodicalIF":2.8,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40349433","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":"Position of Sulfonylureas in the Current ERA: Review of National and International Guidelines.","authors":"Viswanathan Mohan, Banshi Saboo, Jabbar Khader, Kirtikumar D Modi, Sushil Jindal, Subhash Kumar Wangnoo, Sugumaran Amarnath","doi":"10.1177/11795514221074663","DOIUrl":"10.1177/11795514221074663","url":null,"abstract":"<p><p>Sulfonylureas (SUs) are one of the commonly prescribed oral anti-hyperglycemic agents (AHA) in low- and middle-income countries (LMICs), either in combination with metformin therapy or alone. However, concern about cardiovascular safety has limited the use of SUs in the management of type 2 diabetes mellitus (T2DM). Additionally, lack of uniformity in the national and international guidelines regarding the positioning of SUs in the management of diabetes has also been reported. The objective of this review was to assess the various national and international guidelines on diabetes management and understand the recommendations specific to SUs in various scenarios. A total of 33 national and international guidelines on the management of T2DM published in English were evaluated. These guidelines have considered the latest evidence and suggest the use of certain second-generation SUs as second-line therapy or in combination with other AHAs in select population and specific scenarios. Identification of the appropriate population, classification based on underlying risk, thorough assessment of the comorbid conditions, and a step-wise approach for the selection of appropriate SUs is essential for the effective management of T2DM. Additionally, cost-to-benefit ratio should be considered, particularly in LMICs, and SUs could continue to play an important role in such settings.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"15 ","pages":"11795514221074663"},"PeriodicalIF":2.7,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/2a/10.1177_11795514221074663.PMC8854230.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39648012","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":"Potential Therapeutic Role for Apelin and Related Peptides in Diabetes: An Update.","authors":"Ethan S Palmer,&nbsp;Nigel Irwin,&nbsp;Finbarr Pm O'Harte","doi":"10.1177/11795514221074679","DOIUrl":"https://doi.org/10.1177/11795514221074679","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is an epidemic with an ever-increasing global prevalence. Current treatment strategies, although plentiful and somewhat effective, often fail to achieve desired glycaemic goals in many people, leading ultimately to disease complications. The lack of sustained efficacy of clinically-approved drugs has led to a heightened interest in the development of novel alternative efficacious antidiabetic therapies. One potential option in this regard is the peptide apelin, an adipokine that acts as an endogenous ligand of the APJ receptor. Apelin exists in various molecular isoforms and was initially studied for its cardiovascular benefits, however recent research suggests that it also plays a key role in glycaemic control. As such, apelin peptides have been shown to improve insulin sensitivity, glucose tolerance and lower circulating blood glucose. Nevertheless, native apelin has a short biological half-life that limits its therapeutic potential. More recently, analogues of apelin, particularly apelin-13, have been developed that possess a significantly extended biological half-life. These analogues may represent a promising target for future development of therapies for metabolic disease including diabetes and obesity.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"15 ","pages":"11795514221074679"},"PeriodicalIF":2.8,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933191","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}