Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

{"title":"Malnutrition-related diabetes mellitus: Rushing toward “type 5” amid unresolved questions and limited evidence","authors":"Anoop Misra ,&nbsp;Shashank Joshi ,&nbsp;Ambrish Mithal","doi":"10.1016/j.dsx.2025.103250","DOIUrl":"10.1016/j.dsx.2025.103250","url":null,"abstract":"<div><h3>Aim</h3><div>To critically evaluate the historical context, diagnostic ambiguity, epidemiological relevance, and recent proposals to reclassify malnutrition-related diabetes mellitus (MRDM) amid changing nutritional landscapes and existing metabolic data.</div></div><div><h3>Methods</h3><div>This review synthesizes data from early clinical reports, WHO documents, epidemiological studies, and recent literature on malnutrition and diabetes. Emphasis is placed on diagnostic inconsistencies, the overuse of low BMI as a surrogate for malnutrition, and evolving nutrition trends in India and low- and middle-income countries (LMICs).</div></div><div><h3>Results</h3><div>MRDM was initially associated with protein-energy malnutrition, low BMI, and insulin-requiring but ketosis-resistant diabetes. However, overlap with other diabetes types, especially autoimmune forms, has raised doubts about its distinct identity. Low BMI is an unreliable proxy for malnutrition in often constitutionally lean populations in LMICs. A 2022 study suggested insulin secretory defects in MRDM, but was limited by small, male-only samples and lack of follow-up. Proposals to classify MRDM as “type 5 diabetes” are questionable, as types 3 and 4 lack formal recognition. Moreover, declining undernutrition rates in LMICs further diminish MRDM's current relevance. Emerging evidence also indicates malnutrition may be more often a consequence than a cause of diabetes.</div></div><div><h3>Conclusion</h3><div>Given its heterogeneity, diagnostic uncertainty, and diminishing epidemiological significance, reclassifying MRDM as a distinct type of diabetes (“type 5 diabetes”) is presently unwarranted. Future classification efforts should prioritize data-driven subtypes with clear therapeutic and prognostic implications, rather than reviving outdated constructs with limited contemporary utility.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103250"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329651","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":"Highlights of the current issue","authors":"Ningjian Wang ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2025.103257","DOIUrl":"10.1016/j.dsx.2025.103257","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103257"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517145","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":"Prediction of retinopathy risk: A prospective cohort study in China","authors":"Xiaohan Xu ,&nbsp;Duolao Wang ,&nbsp;Uazman Alam ,&nbsp;Shanhu Qiu ,&nbsp;Yuzhi Ding ,&nbsp;Zilin Sun ,&nbsp;Anupam Garrib","doi":"10.1016/j.dsx.2025.103251","DOIUrl":"10.1016/j.dsx.2025.103251","url":null,"abstract":"<div><h3>Aim</h3><div>To identify risk factors for retinopathy and to develop a nomogram for individualised risk prediction in a multi-ethnic Chinese cohort.</div></div><div><h3>Methods</h3><div>Data were derived from the SENSIBLE-Cohort, excluding participants with retinopathy at baseline. Two nomograms were constructed: one using baseline data only (Baseline), and one incorporating baseline and follow-up data (Combination). Predictor selection involved Cox regression, Boruta, least absolute shrinkage and selection operator (LASSO), and recursive feature elimination (RFE). Model performance was evaluated using Harrell's C-index, confusion matrix, and Brier Score. The receiver operating characteristic (ROC) curves, the area under the ROC curve (AUC), the DeLong test, and the decision curve analysis (DCA) were used for comparative assessment.</div></div><div><h3>Results</h3><div>A total of 2,447 participants were included (mean age: 53.0 ± 8.6 years; 66.1 % female; BMI: 25.4 ± 3.5 kg/m²), including 1,380 with normal glucose tolerance, 762 with prediabetes, and 305 with diabetes. During follow-up, 144 (5.9 %) people developed retinopathy. Key predictors included BMI, waist-to-hip ratio, triglycerides, systolic and diastolic blood pressure, hypertension history, and ethnicity.</div><div>The Combination nomogram showed superior discrimination compared to the Baseline nomogram (AUC: 0.75 vs. 0.64, P &lt; 0.001) and demonstrated balanced sensitivity and specificity. DCA demonstrated greater clinical utility of the Combination nomogram across a range of risk thresholds.</div></div><div><h3>Conclusion</h3><div>The Combination nomogram enables early retinopathy risk stratification using accessible clinical data. It may support personalised screening and introduces the broader concept of metabolic retinopathy.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103251"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240565","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":"The effect of flaxseed supplementation on anthropometric indices, blood pressure, and lipid profile in diabetic patients: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials","authors":"Vali Musazadeh ,&nbsp;Shokufeh Nezamoleslami ,&nbsp;Amir Hossein Faghfouri ,&nbsp;Farzad Shidfar ,&nbsp;Naheed Aryaeian","doi":"10.1016/j.dsx.2025.103241","DOIUrl":"10.1016/j.dsx.2025.103241","url":null,"abstract":"<div><h3>Background and aims</h3><div>Numerous clinical studies have suggested that flaxseed supplementation may be effective in diabetic patients, but the findings are controversial. Therefore, this study aimed to examine the effects of flaxseed on blood pressure, anthropometry, and lipid profile parameters in diabetic patients.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched until June 2024. A random-effects model was utilized to analyze standardized mean differences (SMDs).</div></div><div><h3>Results</h3><div>Meta-analysis of 16 trials with 1136 participants indicated significant improvements in weight (SMD: 0.81; 95 % CI: 1.54 to −0.09, p = 0.028; <em>I</em>² = 88.7 %, p &lt; 0.001), waist circumference (SMD: 1.54; 95 % CI: 2.77 to −0.31, p = 0.002; <em>I</em>² = 85.3 %, p &lt; 0.001), and triglyceride (SMD: 0.56; 95 % CI: 1.02 to −0.10, p = 0.016; <em>I</em>² = 87.4 %, p &lt; 0.001), but not BMI (SMD: 0.63; 95 % CI: 1.28 to 0.02, p = 0.058; <em>I</em>² = 87.9 %, p = 0.005), systolic blood pressure (SMD: 0.50; 95 % CI: 1.25, 0.25, p = 0.193; <em>I</em>² = 87.6 %, p &lt; 0.001), diastolic blood pressure (SMD: 0.74; 95 % CI: 1.51, 0.03, p = 0.060; <em>I</em>² = 88.1 %, p &lt; 0.001), total cholesterol (SMD: 0.43; 95 % CI: 0.99 to 0.12, p = 0.128; <em>I</em>² = 93.6 %, p &lt; 0.001), low-density lipoprotein cholesterol (SMD: 0.09; 95 % CI: 0.87 to 0.70, p = 0.830; <em>I</em>² = 96.3 %, p &lt; 0.001), and high-density lipoprotein cholesterol (SMD: 0.08; 95 % CI: 0.30 to 0.46, p = 0.673; <em>I</em>² = 87.2 %, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Flaxseed supplementation effectively reduces anthropometric indices and triglyceride levels in individuals with type 2 diabetes but does not suggest any benefit on blood pressure and other lipid profile parameters. Therefore, conducting more extensive, well-designed trials to validate these findings is crucial.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103241"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240566","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":"The effectiveness of telemedicine in the prevention of type 2 diabetes mellitus: a systematic review and meta-analysis of interventions","authors":"Laura Suhlrie ,&nbsp;Raga Ayyagari ,&nbsp;Camille Mba ,&nbsp;Kjell Olsson ,&nbsp;Harold Torres-Aparcana ,&nbsp;Steven James ,&nbsp;Elpida Vounzoulaki ,&nbsp;Daniel B. Ibsen","doi":"10.1016/j.dsx.2025.103252","DOIUrl":"10.1016/j.dsx.2025.103252","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk.</div></div><div><h3>Methods</h3><div>Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010–December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analysed, and other intervention designs narratively synthesized.</div></div><div><h3>Results</h3><div>We identified 11,645 studies via database searches, of which 226 were full-text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): −1.66 kg, 95 % confidence interval (CI) −2.48,-0.90, I² = 81 %, n_studies = 17), body mass index (MD -0.71 kg/m², 95 % CI -1.06,-0.37, I² = 70 %, n_studies = 11), waist circumference (MD -2.82 cm, 95 % CI -5.16,-2.35, I² = 84 %, n_studies = 8) and HbA1c (MD -0.07 %, 95 % CI -0.14,0.00, I² = 71 %, n_studies = 11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. The longest follow-up time was up to 24 months.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates effectiveness for telemedicine-delivered interventions in preventing T2D in people at risk, specifically in people with overweight/obesity.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103252"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291007","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":"Adiposity at the core of the rising tide of young-onset type 2 diabetes worldwide","authors":"Naveed Sattar FMedSci ,&nbsp;Anoop Misra MD","doi":"10.1016/j.dsx.2025.103249","DOIUrl":"10.1016/j.dsx.2025.103249","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103249"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263209","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":"Prevalence of cardiovascular risk and atherosclerotic cardiovascular disease in people with type 2 diabetes in the United Arab Emirates: Results from the prevalence of atherosclerotic cardiovascular disease in patients with type 2 diabetes across Middle East and African countries (PACT-MEA) study","authors":"Fatheya Al. Awadi ,&nbsp;Fauzia Rashid ,&nbsp;Ghada Awada ,&nbsp;Haitham Seifeldin ,&nbsp;Hani Sabbour ,&nbsp;Hazem Aly ,&nbsp;Jalal Nafach ,&nbsp;Khadija Hafidh ,&nbsp;Loai Abudaqa ,&nbsp;Mahir K. Jallo ,&nbsp;Wael Almahmeed ,&nbsp;Zufana Nazir","doi":"10.1016/j.dsx.2025.103224","DOIUrl":"10.1016/j.dsx.2025.103224","url":null,"abstract":"<div><h3>Aim</h3><div>Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.</div></div><div><h3>Methods</h3><div>Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.</div></div><div><h3>Results</h3><div>Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).</div></div><div><h3>Conclusion</h3><div>Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103224"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834272","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":"Quantitative assessment of metabolic memory and its prediction of renal function decline in patients with type 2 diabetes: A retrospective observational study","authors":"Kentaro Oniki ,&nbsp;Takuro Shigaki ,&nbsp;Ayami Kajiwara-Morita ,&nbsp;Keiichi Shigetome ,&nbsp;Akira Yoshida ,&nbsp;Hideaki Jinnouchi ,&nbsp;Junji Saruwatari","doi":"10.1016/j.dsx.2025.103225","DOIUrl":"10.1016/j.dsx.2025.103225","url":null,"abstract":"<div><h3>Aims</h3><div>This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUC_{HbA1c ≥ 6 %}) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUC_{HbA1c ≥ 6 %}.</div></div><div><h3>Results</h3><div>The relationship between AUC_{HbA1c ≥ 6 %} and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.</div></div><div><h3>Conclusions</h3><div>We developed an AUC_{HbA1c ≥ 6 %}-based model to predict renal function decline in patients with T2D, showing that AUC_{HbA1c ≥ 6 %} may serve as a quantitative indicator of metabolic memory.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103225"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834273","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":"Highlights of the current issue","authors":"Ningjian Wang ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2025.103240","DOIUrl":"10.1016/j.dsx.2025.103240","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103240"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184439","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":"Composite renal outcome in prospectively performed biopsy proven diabetic kidney disease versus non-diabetic kidney disease: A longitudinal follow up","authors":"Subhasis Neogi ,&nbsp;Madhurima Basu ,&nbsp;Pradip Mukhopadhyay ,&nbsp;Arpita Ray Chaudhury ,&nbsp;Nitai P. Bhattacharyya ,&nbsp;Sujoy Ghosh","doi":"10.1016/j.dsx.2025.103237","DOIUrl":"10.1016/j.dsx.2025.103237","url":null,"abstract":"<div><h3>Aims</h3><div>This study was undertaken to evaluate differences in composite renal outcomes between diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) (prospectively performed, biopsy proven), along with predictors of renal outcome in subjects with DKD.</div></div><div><h3>Methods</h3><div>A composite renal outcome comprising of doubling of creatinine, end stage renal disease (ESRD) or renal death was documented in biopsy proven DKD and NDKD subjects. Differences in outcome (DKD vs. NDKD) were compared. Clinical, biochemical and histopathological parameters were evaluated as possible predictors of composite renal outcome in DKD.</div></div><div><h3>Results</h3><div>91 subjects (72 DKD and 19 NDKD) were included for analysis. The hazard ratio (HR) for composite renal outcome was 0.27 (0.08–0.9) (p = 0.03) in favour of NDKD. Kaplan-Meier analysis demonstrated NDKD subjects had better composite renal outcome compared to DKD (log rank chi-square 6.69, p = 0.009). Degree of proteinuria and renal pathology society (RPS) class (III/IV) predicted worse outcome in those with DKD.</div></div><div><h3>Conclusions</h3><div>Composite renal outcomes in NDKD was better as compared to those with DKD. RPS class III/IV on histopathology and degree of proteinuria was associated with poorer composite renal outcome in patients with DKD.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103237"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123409","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}