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

{"title":"Low dose pioglitazone (7.5 mg) provides efficacious glycemic control in Asian Indian patients with poorly controlled diabetes compared to 15 mg: A pilot randomized controlled parallel-group open-label trial over 12 months","authors":"Rohit Barnabas ,&nbsp;Shruti Bhide ,&nbsp;Saba Samad Memon ,&nbsp;Manjiri Karlekar ,&nbsp;Chetan Phirke ,&nbsp;Saurabh Patil ,&nbsp;Vijayadhaarani Sekar ,&nbsp;Vyankatesh Shivane ,&nbsp;Anurag Lila ,&nbsp;Tushar Bandgar","doi":"10.1016/j.dsx.2025.103335","DOIUrl":"10.1016/j.dsx.2025.103335","url":null,"abstract":"<div><h3>Aims</h3><div>We aimed to compare the 1-year efficacy and safety of 7.5 mg versus 15 mg pioglitazone in Asian Indian patients with type 2 diabetes due to lack of long-term data in lower doses.</div></div><div><h3>Methods</h3><div>In this open-label randomized controlled study, 60 patients were assigned to receive either 7.5 mg or 15 mg of pioglitazone daily. Efficacy endpoints included HbA1c, fasting and postprandial venous glucose. Additionally, lipid profile, liver enzymes, and DXA-based body composition, BMD, weight gain, hemoglobin, and adverse events were performed.</div></div><div><h3>Results</h3><div>Both doses achieved significant HbA1c reduction from baseline (−0.95 % in 7.5 mg, −0.9 % in 15 mg) and postprandial venous glucose (median absolute difference −50 and −46 mg/dl), with non-inferiority of the lower dose. Weight gain occurred in both groups (0.95 kg vs 1.3 kg), mainly due to increased fat mass, with a trend toward greater and earlier gain in the 15 mg arm. Lipid parameters, hepatic enzymes, and body composition parameters were comparable across arms, while there was significant reduction in SGOT and VLDL within individual groups. No significant differences in hypoglycemia, edema, BMD loss, or fractures were observed. The major limitations of the study were open label design, single tertiary care center setting, imperfect randomization in fasting glucose, LDL, and total cholesterol between groups and missing data in DXA scan at follow up.</div></div><div><h3>Conclusion</h3><div>Pioglitazone 7.5 mg is an effective and well-tolerated alternative to 15 mg in Asian Indian patients with type 2 diabetes.</div></div><div><h3>Clinical trials registry of india registration number</h3><div>CTRI/2021/09/036149.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103335"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617461","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":"Gliclazide in type 2 diabetes: Cost-effective and clinically relevant in resource-limited settings","authors":"Banshi Saboo ,&nbsp;Nitin Kapoor ,&nbsp;Balaji Jaganmohan ,&nbsp;Abdul Zargar ,&nbsp;Saptarshi Bhattacharya ,&nbsp;Rakesh Sahay ,&nbsp;Shehla Shaikh ,&nbsp;J.J. Mukherjee","doi":"10.1016/j.dsx.2025.103336","DOIUrl":"10.1016/j.dsx.2025.103336","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103336"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650314","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":"Impact of sodium-glucose co-transporter-2 inhibitor combined with mineralocorticoid receptor antagonist therapy versus either agent alone in individuals with chronic kidney disease: A systematic review and meta-analysis","authors":"Deep Dutta ,&nbsp;A.B.M. Kamrul-Hasan ,&nbsp;Sweekruti Jena ,&nbsp;Kunal Mahajan ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2025.103334","DOIUrl":"10.1016/j.dsx.2025.103334","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose co-transporter-2 inhibitor (SGLT2i) with mineralocorticoid receptor antagonist (MRA) combination therapy (SMCT) hypothetically appears feasible and rational, given their complementary mechanisms of action. This systematic review and meta-analysis (SRM) assessed the effectiveness and safety of SMCT compared to either agent alone in CKD.</div></div><div><h3>Methods</h3><div>Electronic databases were searched for articles evaluating SMCT in CKD as compared to SGLT2i or MRA alone. The primary outcome was percent-change in urine albumin-to-creatinine ratio (UACR%). Secondary outcomes were changes in glomerular filtration-rate (eGFR), UACR&gt;30 % decline, systolic blood pressure (SBP), potassium, total adverse-events (TAEs), severe adverse-events (SAEs), hypotension and acute kidney injury (AKI).</div></div><div><h3>Results</h3><div>Data from 8 studies (15,583 adults) having age 53–76 years, BMI 28–33 kg/m², HbA1c 6–8 % and eGFR 32–73 ml/min/1.73 m² were analyzed. SMCT was associated with significant reduction in UACR % as compared to MRA [MD-12.83 %(95 %CI: 19.49,-6.17); P &lt; 0.001; I² = 93 %] or SGLT2i [MD-26.30 % (95 %CI: 31.93,-20.68); P &lt; 0.001; I² = 60 %]. SMCT users had significantly higher chances of &gt;30 % reduction in UACR compared to MRA [OR6.69(95 %CI:2.00,22.43); P = 0.002; I² = 80 %] or SGLT2i [OR 4.87(95 %CI:1.71,13.83); P &lt; 0.001; I² = 86 %. SMCT users had significantly lower SBP compared to MRA [MD-5.89 mm-Hg(95 %CI: 9.74,-2.04); P = 0.003; I² = 0 %] or SGLT2i [MD-3.49 mm-Hg(95 %CI: 6.64,-0.34); P = 0.03; I² = 0 %]. SMCT users had similar potassium compared to MRA [MD0.08 mmol/L (95 %CI: 0.34,0.50); P = 0.71; I² = 92 %] but higher compared to SGLT2i [MD0.18 mmol/L (95 %CI:0.07,0.29); P = 0.002; I² = 48 %]. SMCT users had TAEs and SAEs similar to MRA, but higher TAEs than SGLT2i. SMCT users had death rates similar to MRA [OR0.33(95 % CI:0.09,1.16); P = 0.08; I² = 0 %] but higher than SGLT2i [OR2.35(95 %CI:1.25,4.40); P = 0.008; I² = 0 %]. SMCT had no impact on eGFR compared to MRA [MD-0.30 ml/min/1.73 m² (95 %CI: 3.11, 2.50); P = 0.83; I² = 0 %] but lower compared to SGLT2i [MD-2.81 ml/min/1.73 m²(95 %CI: 5.06,-0.56); P = 0.01; I² = 0 %]. The occurrence of hypotension and AKI were similar among study groups.</div></div><div><h3>Conclusion</h3><div>SMCT is more effective than MRA or SGLT2i alone in reducing urine protein loss in CKD. SMCT has side-effects profile like MRAs, which is higher than SGLT2i.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103334"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145663419","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":"Response to letter to the editor by Mondal H et al. “Delayed breakfast in type 2 diabetes: Critical gaps and translation barriers”","authors":"Ana Paula Bravo-Garcia,&nbsp;Evelyn B. Parr","doi":"10.1016/j.dsx.2025.103332","DOIUrl":"10.1016/j.dsx.2025.103332","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103332"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673330","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":"Burden and trends of diabetic kidney disease in East Asia, 1990–2038: An analysis of the global burden of disease study 2023","authors":"Shuai Lin ,&nbsp;Ruxin Liu ,&nbsp;Guodong Zhong ,&nbsp;Peilin Lyu ,&nbsp;Li Liu ,&nbsp;Bing Zhang ,&nbsp;Juan Xu ,&nbsp;Yanlin Li","doi":"10.1016/j.dsx.2025.103333","DOIUrl":"10.1016/j.dsx.2025.103333","url":null,"abstract":"<div><h3>Aim</h3><div>Diabetic kidney disease is a major cause of chronic and end-stage kidney disease. East Asia, home to one-third of the world's people living with diabetes, is undergoing rapid demographic and metabolic transitions.</div></div><div><h3>Methods</h3><div>Using Global Burden of Disease 2023 data, we assessed diabetic kidney disease burden in China, Japan, the Republic of Korea, the Democratic People's Republic of Korea, and Mongolia from 1990 to 2023, and projected trends to 2038. We analyzed incidence, prevalence, mortality, and disability-adjusted life years, separated demographic and epidemiologic effects, and applied time-series forecasting.</div></div><div><h3>Results</h3><div>East Asia showed moderate prevalence but low mortality compared with global levels, with pronounced differences between countries. China showed rising incidence and falling mortality; Japan and Mongolia exhibited ageing-related rebounds; Korea stabilized; and the Democratic People's Republic of Korea remained largely unchanged. Metabolic risks—especially high blood glucose and obesity—were the leading contributors. Ageing was the dominant driver of increases in cases and deaths, partly offset by epidemiologic gains. Forecasts to 2038 indicate persistent heterogeneity.</div></div><div><h3>Conclusions</h3><div>Diabetic kidney disease in East Asia reflects the shift toward chronic metabolic disease, with rising burden despite improved survival. Strengthening early detection and expanding access to kidney-protective therapy are essential to reduce future impact.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103333"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617462","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 (Associate Editor) ,&nbsp;Anoop Misra (Editor-in-Chief)","doi":"10.1016/j.dsx.2025.103354","DOIUrl":"10.1016/j.dsx.2025.103354","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 11","pages":"Article 103354"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737862","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 and risk factors of hypovitaminosis D among patients with diabetes mellitus from India: A systematic review and meta-analysis","authors":"Gaurab Bhaduri ,&nbsp;Shambo Samrat Samajdar ,&nbsp;Subhro Chakraborty ,&nbsp;Banshi Saboo ,&nbsp;Shashank R. Joshi","doi":"10.1016/j.dsx.2025.103326","DOIUrl":"10.1016/j.dsx.2025.103326","url":null,"abstract":"<div><h3>Background</h3><div>There is considerable evidence regarding the potential risk of hypovitaminosis D for various chronic conditions, including type 2 diabetes mellitus (T2DM). Although India essentially shares a tropical climate, it reports a high prevalence of vitamin D deficiency that is predominant in people with diabetes. This systematic review and meta-analysis were designed to look into the risk factors associated with hypovitaminosis D in diabetic patients from India and assess the prevalence.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Cochrane Library were searched systematically for observational studies reporting the serum vitamin D levels of T2DM patients up to September 2024. A random effects model was employed to analyse the pooled prevalence of hypovitaminosis D and its risk factors.</div></div><div><h3>Results</h3><div>Twelve studies of 8953 patients with diabetes (sample size) were included in the review. The combined prevalence of hypovitaminosis D was 79 % (95 % CI: 75 %–84 %, i² = 97 %). Mean serum vitamin D level was 17.21 ng/mL (95 % CI: 16.87–17.56 ng/mL). More frequently noted risk factors included duration of diabetes, fatigue, body mass index, and HbA1c levels. However, the findings are limited by substantial heterogeneity, predominance of cross-sectional designs, and a paucity of high-quality, well-controlled studies from India.</div></div><div><h3>Conclusion</h3><div>Hypovitaminosis D is highly prevalent in Type 2 diabetes mellitus patients in India, with the level highly below optimum thresholds. Routine screening of vitamin D levels and targeted supplementation strategies may further improve metabolic control and reduce complications among this vulnerable population.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 10","pages":"Article 103326"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579870","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":"Letter to editor: Malnutrition-related diabetes mellitus: Rushing toward “type 5” amid unresolved questions and limited evidence","authors":"Alok Bhatt ,&nbsp;Pentela Bhavani ,&nbsp;Ashwini Kumar Sapate ,&nbsp;Fayaz Ahamed","doi":"10.1016/j.dsx.2025.103315","DOIUrl":"10.1016/j.dsx.2025.103315","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 10","pages":"Article 103315"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145448494","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":"Short-term 24h dietary recalls from observational studies cannot support claims on mortality","authors":"Emily N.C. Manoogian ,&nbsp;Courtney M. Peterson ,&nbsp;Dorothy D. Sears ,&nbsp;Mary Playdon ,&nbsp;Siobhan Banks ,&nbsp;Maxine Bonham ,&nbsp;Amandine Chaix ,&nbsp;Lisa S. Chow ,&nbsp;Adriana Coletta ,&nbsp;Rafael De Cabo ,&nbsp;Paula Desplats ,&nbsp;Charna Dibner ,&nbsp;Kelsey Gabel ,&nbsp;Sheri L. Johnson ,&nbsp;Lance J. Kriegsfeld ,&nbsp;Sheetal Hardikar ,&nbsp;John A. Hawley ,&nbsp;Leonie K. Heilbronn ,&nbsp;John Hogenesch ,&nbsp;Dara L. James ,&nbsp;Tinh-Hai Collet","doi":"10.1016/j.dsx.2025.103316","DOIUrl":"10.1016/j.dsx.2025.103316","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 10","pages":"Article 103316"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498160","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.2025.103344","DOIUrl":"10.1016/j.dsx.2025.103344","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 10","pages":"Article 103344"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693821","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}