Clinical Medicine Insights-Endocrinology and Diabetes最新文献

{"title":"Dyslipidemia in Diabetes: Navigating a Complex Landscape for Improved Cardiovascular Outcomes.","authors":"Roshaida Abdul Wahab, Wan Aizad Wan Mahmood","doi":"10.1177/11795514261422310","DOIUrl":"10.1177/11795514261422310","url":null,"abstract":"<p><p>Cardiovascular diseases are the leading cause of global mortality, accounting for roughly one-third of all deaths. Dyslipidemia is a key risk factor for atherosclerotic cardiovascular disease (ASCVD) and often coexists with diabetes, which exacerbates ASCVD risk. Despite the comprehensive management of dyslipidemia in patients with diabetes through pharmacological and non-pharmacological approaches, many individuals struggle to meet lipid targets through lifestyle changes alone. Therefore, pharmacological interventions are essential. Pharmacotherapy options for dyslipidemia in patients with diabetes, including those currently under development, have gained attention, particularly regarding their impact on cardiovascular outcomes. In this narrative review, we explore the data on cardiovascular outcomes related to established and emerging pharmacotherapy in the management of dyslipidemia in diabetes, such as statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, icosapent ethyl, inclisiran, other lipid-lowering agents (fibrates, bile acid sequestrants, niacin), and novel medications such as antisense nucleotides and cholesterol ester transfer protein inhibitors. We aim to provide a summary that will help navigate the extensive evidence base on cardiovascular outcomes trials of these agents. We found that statins, particularly atorvastatin, showed the strongest and most consistent evidence on cardiovascular outcomes in patients with diabetes, with high-intensity statin therapy associated with significant reductions in major adverse cardiovascular events (MACE). Therefore, clinicians should prioritize statin therapy as the first-line pharmacotherapy for managing dyslipidemia in patients with diabetes to optimize cardiovascular outcomes. Studies also showed that the duration of statin therapy is the strongest predictor of MACE, followed by the achieved LDL cholesterol level and statin intensity. Additional lipid-lowering agents, such as ezetimibe or PCSK9 inhibitors, should be considered for patients who do not achieve target LDL cholesterol levels or for those who are statin-intolerant.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"19 ","pages":"11795514261422310"},"PeriodicalIF":2.5,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291407","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":"C-peptide in Precision Diabetes Care and Beyond: A Comprehensive Review.","authors":"Eligar Somashekar Vinay, Bondugulapati Laxmi Narsimha Rao, Naqvi Saf, Das Gautam","doi":"10.1177/11795514251397811","DOIUrl":"10.1177/11795514251397811","url":null,"abstract":"<p><p>Impaired pancreatic β-cell function is a key feature in the pathophysiology of both type 1 and long-standing type 2 diabetes. C-peptide, produced in 1:1 ratio along with insulin, is secreted at a relatively steady rate over long duration, making it an effective biomarker for endogenous insulin secretion. Given the heterogeneity and complex pathophysiology of diabetes, C-peptide estimation plays an important role in the accurate classification of diabetes and in guiding treatment decisions, particularly for patients needing insulin therapy. In autoimmune diabetes, especially adult-onset forms, C-peptide has gained importance as a biomarker. However, its greatest utility is often observed 3 to 5 years post-diagnosis, when detectable C-peptide levels may help differentiate between MODY (Maturity-onset Diabetes of the Young) and type 2 diabetes. The clinical applications of C-peptide extend beyond diagnosis, including risk stratification for diabetes-related vascular complications, determining pharmacotherapy choices, evaluating hypoglycemia, and even in the context of bariatric surgery. Despite its usefulness, the role of C-peptide in type 2 diabetes remains limited, primarily due to insulin resistance, which may elevate C-peptide levels. Estimating C-peptide is a cost-effective and reliable method, but there is still considerable variation in its application. Factors such as sample collection, timing in relation to meals, and the lack of standardization in assay techniques raise issues regarding the consistency and repeatability of results among various laboratories. This review aims to explore the current evidence surrounding C-peptide estimation in diabetes care, as well as the limitations and uncertainties that continue to challenge its clinical application.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"19 ","pages":"11795514251397811"},"PeriodicalIF":3.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203254","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":"Corrigendum to \"Irisin in Type 2 Diabetes and Obesity: A Biomarker of Metabolic and Lipid Dysregulation\".","authors":"","doi":"10.1177/11795514251411157","DOIUrl":"https://doi.org/10.1177/11795514251411157","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/11795514251344029.].</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251411157"},"PeriodicalIF":3.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12717371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805809","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":"Metformin Induced Vitamin B12 deficiency: A Cross sectional study. Untangling the connection.","authors":"Arjun Ballal, Sudha Vidyasagar, Vasudev Acharya, Cynthia Amrutha Sukumar","doi":"10.1177/11795514251357419","DOIUrl":"10.1177/11795514251357419","url":null,"abstract":"<p><strong>Background: </strong>Metformin is a widely popular drug to treat type 2 diabetes as it is efficacious, inexpensive and relatively well tolerated with minimal side effect profile. It is known that long term metformin use predisposes a person to develop Vitamin B12 deficiency, however guidelines to screen and treat are yet to be well established. Vitamin B12 deficiency is known to cause peripheral neuropathy and anemia.</p><p><strong>Methods: </strong>Ours is a prospective, observational, cross sectional study based in a hospital setting in a tertiary care center. Study participants were subjected to serum Vitamin B12 analysis and Michigan neuropathy screening instrument was used to screen for peripheral neuropathy.</p><p><strong>Results: </strong>We report statistically significant association between metformin use and development of Vitamin B12 deficiency. The average duration of metformin use that resulted in development of Vitamin B12 deficiency was 13.6 years. We also found statistically significant association of metformin use with development of peripheral neuropathy.</p><p><strong>Conclusion: </strong>Long term metformin leading to Vitamin B12 deficiency is common knowledge, however we need more targeted guidelines on when to screen and treat for B12 deficiency. Some subsets of the population such as elderly and vegetarians are more prone and hence we need to educate more physicians and patients on the same.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251357419"},"PeriodicalIF":3.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12717354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805731","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":"Comment on \"Relationship Between Glycemic Indices and eGFR Values Among Type 2 Diabetes Mellitus Individuals With Chronic Kidney Disease Across Various Progression Stages\".","authors":"Shyam Sundar Sah, Abhishek Kumbhalwar","doi":"10.1177/11795514251407031","DOIUrl":"10.1177/11795514251407031","url":null,"abstract":"","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251407031"},"PeriodicalIF":3.0,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776085","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 Abdominal Obesity and Hyperuricemia in Peruvian Adults with Type 2 Diabetes Mellitus.","authors":"F Guadalupe Peralta-Vera, Enzo Castillo-Céspedes, Lucero Del Carmen Collazos-Huamán, Camila Guerreros-Espino, Percy Herrera-Añazco, Vicente A Benites-Zapata","doi":"10.1177/11795514251403098","DOIUrl":"10.1177/11795514251403098","url":null,"abstract":"<p><strong>Background: </strong>Abdominal obesity (AO) is associated with hyperuricemia (HU) in people with type 2 diabetes (T2DM), but most evidence comes from Asian studies and Latin American data are scarce. This study addresses that gap in a Peruvian setting. We aimed to evaluate the association between AO and HU in adult Peruvians diagnosed with T2DM.</p><p><strong>Methods: </strong>We carried out a cross-sectional observational study in adults with T2DM in a private clinic in Lima - Peru. We defined HU as serum uric acid ⩾ 6 mg/dL and defined AO as waist circumference ⩾ 94 cm in men and ⩾88 cm in women. In addition, we estimated crude and adjusted prevalence ratios (PRs) with 95% CIs for the AO-HU association, adjusting for sex, glycosylated hemoglobin, estimated glomerular filtration rate, and systolic/diastolic blood pressure.</p><p><strong>Results: </strong>We evaluated 815 adults with T2DM. 62.6% were male, and the average age was 57 years. AO was present in 82.9% and HU in 22.7%. The prevalence of HU in adults with AO was 24.3%, while the prevalence was 15.1% in those not obese. AO was associated with HU in the crude analysis (cPR: 1.60 95% CI 1.05-2.43) and remained statistically significant after adjustment for sex, glycosylated hemoglobin, estimated glomerular filtration rate, and systolic/diastolic blood pressure (aPR: 1.95 95% CI 1.31-2.90).</p><p><strong>Conclusion: </strong>In Peruvian adults with T2DM, abdominal obesity was associated with nearly double the prevalence of hyperuricemia. Because waist circumference is simple and low-cost to measure, integrating it into routine diabetes visits, along with targeted uric acid screening and management, may enhance cardiometabolic risk stratification and guide timely interventions.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251403098"},"PeriodicalIF":3.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758037","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":"Delayed Dexamethasone Absorption from Gluteal Abscesses: Persistent Iatrogenic Cushing Syndrome.","authors":"Domas Grigoravicius, Karolis Laucius, Rasa Ugenskiene, Vaida Stankute, Zydrune Visockiene","doi":"10.1177/11795514251376453","DOIUrl":"10.1177/11795514251376453","url":null,"abstract":"<p><p>Iatrogenic Cushing syndrome can occur due to the use of external glucocorticoids. We present a case involving prolonged exposure to glucocorticoids from intramuscular dexamethasone injections, with diagnosis confirmed via abscess fluid analysis. This underscores the importance of considering altered pharmacokinetics when faced with unexplained hypercortisolism. A 46-year-old woman experienced hypertension, weakness, edema, and increasing abdominal striae over 6 months. Her history included undocumented intramuscular injections for back pain a year earlier, which resulted in bilateral gluteal abscesses. Laboratory results showed suppressed morning cortisol and adrenocorticotrophic hormone levels, while imaging ruled out structural abnormalities. Although serum tests were negative, liquid chromatography-mass spectrometry performed on abscess fluid detected dexamethasone (81.1 nmol/L), confirming iatrogenic Cushing syndrome. This case highlights how local tissue changes, such as abscesses, can significantly modify glucocorticoid pharmacokinetics, creating a prolonged reservoir effect and sustained systemic exposure lasting more than a year after injection. Overall, atypical pharmacokinetics are important in cases of unexplained hypercortisolism, especially when local tissue alterations influence drug absorption and clearance. Analyzing collections like abscess fluid can provide vital diagnostic clues in complex suspected cases of iatrogenic Cushing syndrome.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251376453"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679065","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":"Sex-Specific Associations of Prolactin and Progesterone With Glycemic Control in Adults With Type 1 Diabetes.","authors":"Abigayle B Simon, Dhruti Trivedi, Jeffrey Thomas, Matthew S Nicholson, Ryan A Harris","doi":"10.1177/11795514251394434","DOIUrl":"10.1177/11795514251394434","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) is an autoimmune disease characterized by insulin deficiency and impaired glucose regulation. While sex hormones are known to influence insulin sensitivity, their specific roles in T1D remain underexplored. Prolactin and progesterone have been associated with glucose metabolism, yet their influence in individuals with T1D, particularly men, has not been well studied. This study investigated the relationship between key sex hormones and glycemic control in men and women with T1D.</p><p><strong>Methods: </strong>Seventy-eight adults with T1D (25 men, 53 women) were recruited for a cross-sectional study examining associations between circulating sex hormone concentrations and hemoglobin A_1c (HbA_1c). Participants underwent anthropometric and body composition assessments and provided fasting blood samples for measurement of estradiol, progesterone, prolactin, total testosterone, free testosterone, and HbA_1c. Pearson's correlations were used to evaluate associations between hormone levels and HbA_1c.</p><p><strong>Results: </strong>In men, higher concentrations of prolactin (<i>r</i> = -.571, <i>P</i> = .003) and progesterone (<i>r</i> = -.434, <i>P</i> = .030) were significantly associated with lower HbA_1c. No such associations were observed in women for prolactin, progesterone, estradiol, or testosterone. Similarly, in men, estradiol, total testosterone, and free testosterone were not significantly correlated with HbA_1c.</p><p><strong>Conclusions: </strong>This study provides novel evidence that prolactin and progesterone may be linked to improved glycemic control in men with T1D. These associations were not observed in women. The findings underscore the importance of sex-specific approaches in endocrine and metabolic research. Further longitudinal and mechanistic studies are needed to confirm these relationships and explore the potential of prolactin and progesterone as therapeutic targets in T1D management.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251394434"},"PeriodicalIF":3.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655783","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":"Corrigendum to \"Role of Supplementation with Selenium and Myo-inositol vs. Selenium alone in patients of Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis\".","authors":"","doi":"10.1177/11795514251395247","DOIUrl":"10.1177/11795514251395247","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/11795514241300998.].</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251395247"},"PeriodicalIF":3.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497242","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":"Relationship Between Glycemic Indices and eGFR Values Among Type 2 Diabetes Mellitus Individuals With Chronic Kidney Disease Across Various Progression Stages.","authors":"K Vaishali, Chandana Acharya, Shobha U Kamath, Revati Amin, Shivashankara Kaniyoor Nagri","doi":"10.1177/11795514251362516","DOIUrl":"10.1177/11795514251362516","url":null,"abstract":"<p><strong>Background: </strong>T2DM is a significant contributor to hypoglycemia, mortality, CVD, as well as a leading cause of CKD. Understanding and managing glycosylation discrepancies in T2DM patients with CKD is critical because they are important in disease causation and progression. Aim of this correlation study was to investigate the accuracy of HbA1c and fructosamine as predictors of declining renal function in the context of T2DM, by comparing and evaluating their relationships with eGFR across stages 1 to 5.</p><p><strong>Methods: </strong>We included individuals with T2DM aged over 18 years, diagnosed per ADA guidelines, and potential CKD (stage 1-5) in T2DM patients. Outcomes involved measuring HbA1c and fructosamine levels of all participants.</p><p><strong>Results: </strong>We recruited 424 participants from Department of Medicine, Kasturba Medical College, MAHE, Manipal on OPD & IPD. For patient in CKD stage 1 to 4, a weak positive correlation was noticed between HbA1c and eGFR. For patient in CKD stage 1 to 4, a weak negative correlation was found between eGFR and Fructosamine.</p><p><strong>Conclusion: </strong>For determining long-term blood sugar management and forecasting the course of kidney disease in individuals with type 2 diabetes, the HbA1c test remains a crucial and dependable tool. However, it might occasionally be more difficult to interpret HbA1c values in later stages of CKD. Fructosamine, a shorter-term blood sugar indicator, can offer useful further information in certain situations. We advise combining the 2 tests for optimal diabetes management: fructosamine for prompt medication modifications, particularly in advanced CKD and HbA1c for long term trends and risk assessments.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251362516"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12580507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446108","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}