World Journal of Diabetes最新文献

{"title":"Coronary imaging characteristics and risk factors in patients with type 2 diabetes mellitus with coronary heart disease complication.","authors":"Chang-Jie Pan, Tao Wang, Ruo-Han Yin, Xiao-Qiang Tang, Chun-Hong Hu","doi":"10.4239/wjd.v16.i4.99151","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.99151","url":null,"abstract":"<p><strong>Background: </strong>Coronary heart disease (CHD) is a prevalent type 2 diabetes mellitus (T2DM) complication. Further, the risk stratification before angiography may help diagnose T2DM with CHD early. However, few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.</p><p><strong>Aim: </strong>To compare the differences in coronary imaging between patients with T2DM with and without CHD, determine the risk factors of T2DM complicated with CHD, and establish a predictive tool for diagnosing CHD in T2DM.</p><p><strong>Methods: </strong>This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024. They are categorized based on CHD occurrence into: (1) The control group, consisting of patients with T2DM without CHD; and (2) The observation group, which includes patients with T2MD with CHD. Age, sex, smoking and drinking history, CHD family history, metformin (MET) treatment pre-admission, body mass index, fasting blood glucose (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), serum creatinine, blood urea nitrogen (BUN), alanine aminotransferase, aspartate aminotransferase, glycosylated hemoglobin (HbA1c), and coronary imaging data of both groups were collected from the medical record system. Logistic risk analysis was conducted to screen risk factors. The prediction model's prediction efficiency was evaluated with receiver operating characteristic curves.</p><p><strong>Results: </strong>The control and observation groups consisted of 48 and 55 cases, respectively. The two groups were statistically different in terms of age (<i>t</i> = 2.006, <i>P</i> = 0.048), FBG (<i>t</i> = 6.038, <i>P</i> = 0.000), TG (<i>t</i> = 2.015, <i>P</i> = 0.047), LDL-C (<i>t</i> = 2.017, <i>P</i> = 0.046), and BUN (<i>t</i> = 2.035, <i>P</i> = 0.044). The observation group demonstrated lower proportions of patients receiving MET (<i>χ</i> <sup>2</sup> = 5.073, <i>P</i> = 0.024) and higher proportions of patients with HbA1c of > 7.0% (<i>χ</i> <sup>2</sup> = 6.980, <i>P</i> = 0.008) than the control group. The observation group consisted of 15, 17, and 23 cases of moderate stenosis, severe stenosis, and occlusion, respectively, with a greater number of coronary artery occlusion cases than the control group (<i>χ</i> <sup>2</sup> = 6.399, <i>P</i> = 0.041). The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group (<i>χ</i> <sup>2</sup> = 15.420, <i>P</i> = 0.000). The observation group demonstrated a higher right coronary artery (RCA) stenosis index (<i>t</i> = 6.730, <i>P</i> = 0.000), circumflex coronary artery (LCX) stenosis index (<i>t</i> = 5.738, <i>P</i> = 0.000), and total stenosis index (<i>t</i> = 7.049, <i>P</i> = 0.000) than the control group. FBG [odds ratio (OR) = 1.472; 95% confidence interval (CI): 1.234-1.75","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"99151"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plantamajoside mitigates endoplasmic reticulum stress-mediated pancreatic β-cell apoptosis in type 2 diabetes <i>via</i> DNAJC1 upregulation.","authors":"Md Abdul Alim Al-Bari, Fabian Davamani, Payal Bhatnagar, Nabil Eid","doi":"10.4239/wjd.v16.i4.104241","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.104241","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is a metabolic disorder characterized by persistent hyperglycemia and other symptoms, which pose significant challenges to individual health, life expectancy, and public healthcare systems. The escalating global prevalence of diabetes underscores the need for innovative therapeutic interventions. In this article, we critically comment on the study by Wang <i>et al</i>, published in the <i>World Journal of Diabetes</i>, which elucidates the therapeutic potential of Plantamajoside (PMS) in type 2 DM (T2DM) management. The authors provide evidence for the mechanism of action of PMS in T2DM models, demonstrating prevention of endoplasmic reticulum stress and apoptosis of pancreatic β-cells <i>via</i> activation of DNAJC1. This manuscript provides a brief review of the pathogenesis of T2DM, explores the various roles of PMS in disease therapy in addition to the DNAJC-related apoptotic and autophagic functions, critically evaluates the experimental approaches employed by Wang <i>et al</i>, and provides recommendations for advancing future research.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"104241"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jejunoileal side-to-side anastomosis as a promising option for type 2 diabetes.","authors":"Sang Yeoup Lee","doi":"10.4239/wjd.v16.i4.103546","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.103546","url":null,"abstract":"<p><p>In this editorial, I discuss the article by Wang <i>et al</i>, published in the <i>World Journal of Diabetes</i>, which explores jejunoileal side-to-side anastomosis as a novel surgical intervention for type 2 diabetes mellitus (T2DM). T2DM, often associated with obesity, remains a global health challenge, as sustained remission is difficult to achieve with conventional pharmacological therapy. Jejunoileal anastomosis offers a promising alternative, particularly for patients with normal or relatively high body mass index, and addresses the unique challenges posed by diverse patient populations. This procedure preserves gastric anatomy while simultaneously improving metabolic parameters, such as glycemic control, lipid profiles, and pancreatic β-cell function. Unlike traditional metabolic surgeries that involve permanent anatomical alterations, this approach provides advantages such as reversibility, shorter operative times, and minimal nutritional complications, making it appealing to patients for whom conventional bariatric surgery is unsuitable. Advances in gut hormone physiology and incretin modulation support these findings. This innovative approach represents a potential paradigm shift in T2DM treatment, offering insights into the evolving role of surgical interventions in metabolic regulation. While early findings show promising diabetes remission rates and metabolic improvements at six months post-surgery, further studies with longer follow-up periods and broader patient cohorts are required.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"103546"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated waist-to-hip ratio, as an abdominal obesity index, predicts the risk of diabetic kidney injury.","authors":"Di-Ni Lin, Dan Li, Meng-Meng Peng, Hong Yang, Zhen-Zhen Lin, En-Ling Ye, Wen-Ting Chen, Meng-Xue Zhou, Xian-En Huang, Xue-Mian Lu","doi":"10.4239/wjd.v16.i4.101384","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.101384","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is associated with a high incidence of type 2 diabetic mellitus (T2DM) in Asia. Central obesity is an important risk factor for DN, represented by a series of indices, including waist circumference, waist-to-hip ratio (WHR), hip circumference, and visceral to subcutaneous fat area ratio (VSR). However, limited research has focused on the association between these indices and DN.</p><p><strong>Aim: </strong>To elucidate the relationship between central fat distribution, as measured by WHR and VSR, and the DN progression.</p><p><strong>Methods: </strong>Between August 2018 and April 2023, a total of 991 individuals were retrospectively recruited from the Rui'an People's Hospital for this cross-sectional analysis. The 753 individuals with T2DM were divided into three groups according to the urinary albumin/creatinine ratio (ACR): normal albuminuria (<i>n</i> = 513, ACR < 30 mg/g), microalbuminuria (<i>n</i> = 166, 30 ≤ ACR < 300 mg/g), and clinical proteinuria (<i>n</i> = 45, ACR ≥ 300 mg/g).</p><p><strong>Results: </strong>Our results indicated that WHR and VSR were closely correlated with sex, ageing, body mass index, hypertension, T2DM causes, and experience of drinking and smoking, and potential relationships between these factors and DN progression were observed. WHR, but not VSR, gradually increased with the severity of early-stage renal injury. Abnormal serum lipid levels in T2DM patients with early-stage renal injury were strongly correlated with WHR. Logistic regression analysis revealed that WHR may be an independent risk factor for early-stage renal injury.</p><p><strong>Conclusion: </strong>In patients with T2DM, WHR level, rather than VSR level, is closely associated with early-stage renal injury. An abnormal serum lipid spectrum was common in all stages of renal injury and was strongly related to high WHR. Thus, WHR measurement might be a valuable tool for the early prevention of renal injury, which could guide clinical monitoring and prevent diabetic complications.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"101384"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive impact of <i>PPARG</i> mutations in familial partial lipodystrophy type 3: Diagnosis, therapeutic strategies.","authors":"Heng-Li Lai, Liu Yang","doi":"10.4239/wjd.v16.i4.103675","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.103675","url":null,"abstract":"<p><p>This article reviews a paper in the <i>World Journal of Diabetes</i>. The study uncovers the link between <i>PPARG</i> gene mutations and metabolic disorders, such as insulin resistance, diabetes, and hypertriglyceridemia, and emphasizes the crucial role of genetic testing in precise diagnosis and personalized treatment. This article further points out that in-depth investigation into the clinical heterogeneity of <i>PPARG</i> mutations and their underlying mechanisms can contribute to optimizing management strategies. Meanwhile, the development of more effective targeted therapies and the conduct of extensive genomic research are of great significance for understanding familial partial lipodystrophy type 3 and related metabolic syndromes.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"103675"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracellular calcium channels: Potential targets for type 2 diabetes mellitus?","authors":"Jia-Xuan Zhu, Zhao-Nan Pan, Dan Li","doi":"10.4239/wjd.v16.i4.98995","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.98995","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder. Despite the availability of numerous pharmacotherapies, a range of adverse reactions, including hypoglycemia, gastrointestinal discomfort, and lactic acidosis, limits their patient applicability and long-term application. Therefore, it is necessary to screen novel therapeutic drugs for T2DM treatment that have high efficacy but few adverse effects. AMP-activated protein kinase (AMPK) stands out as one of the most powerful targets for T2DM treatment. It can be activated through energy-sensing or calcium signaling. Medications that activate AMPK through the energy-sensing mechanism exhibit remarkable potency, but they are accompanied by lactic acidosis, carrying an alarmingly high mortality rate. Interestingly, medications that activate AMPK through calcium signaling, such as gliclazide, seldom induce lactic acidosis. However, the efficacy of gliclazide is much lower than metformin. Therefore, it is necessary to explore targets that activate AMPK <i>via</i> calcium signaling to avoid lactic acidosis while maintaining high potency. Ion channels are the main controller of intracellular calcium flow. Specific agonists and inhibitors targeting ion channels have been reported to activate AMPK. In this review, we will summarize the structure and function of calcium-permeable ion channels and discuss the potential of targeting these calcium channels for T2DM treatment.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"98995"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of systolic blood pressure status on coronary inflammation and high-risk plaque characteristics.","authors":"Cui-Ping Jiang, Yuan-Kang Liu, Pan-Pan Cheng, Yue Dong, Xiang Wang, Fan-Yu Wu, Yu-Xuan Xia, Peng-Yun Wang, Xiang-Yang Xu","doi":"10.4239/wjd.v16.i4.102751","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.102751","url":null,"abstract":"<p><strong>Background: </strong>Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus (T2DM). It remains unclear whether systolic blood pressure (SBP) status of hypertension is related to coronary inflammation and plaques in T2DM.</p><p><strong>Aim: </strong>To evaluate whether SBP variability (SBPV) and levels of hypertension are related to coronary inflammation and plaques in T2DM patients using coronary computed tomography angiography (CCTA).</p><p><strong>Methods: </strong>This retrospective study involved 881 T2DM patients with CCTA images, including 668 hypertension and 213 normotension patients. Hypertension patients were subgroup based on SBP status: (1) SBPV: Low (< 8.96 mmHg) and high (≥ 8.96 mmHg) groups; and (2) SBP levels: Controlled (< 140 mmHg) and uncontrolled (≥ 140 mmHg) groups. Pericoronary adipose tissue (PCAT) attenuation, high-risk plaques (HRPs) and obstructive stenosis (OS) were evaluated by CCTA. Propensity score matching was utilized to compare these CCTA findings for these groups. The impact of SBPV and SBP levels of hypertension on these CCTA findings in T2DM patients were evaluated by multivariate logistic regression and multivariable linear regression.</p><p><strong>Results: </strong>PCAT attenuation of the left anterior descending artery (LAD), any low attenuation plaque (LAP), any spotty calcification (SC), any positive remodeling (PR), and OS had significant differences between the hypertension group and the normotension group, as well as between the high SBPV or uncontrolled SBP group and the low SBPV or controlled SBP group (all <i>P</i> < 0.05). Hypertension was independently positively correlated with LAD-PCAT attenuation (<i>β</i> = 1.815, <i>P</i> = 0.010), LAP (OR = 1.612, <i>P</i> = 0.019), SC (OR = 1.665, <i>P</i> = 0.013), PR (OR = 1.549, <i>P</i> = 0.033), and OS (OR = 1.928, <i>P</i> = 0.036) in all T2DM patients. Additionally, high SBPV and uncontrolled SBP were independently positively correlated with LAD-PCAT attenuation (high SBPV: <i>β</i> = 1.673, <i>P</i> = 0.048; uncontrolled SBP: <i>β</i> = 2.370, <i>P</i> = 0.004) and PR (high SBPV: OR = 1.903, <i>P</i> = 0.048; uncontrolled SBP: OR = 2.230, <i>P</i> = 0.013) in T2DM patients with hypertension.</p><p><strong>Conclusion: </strong>Inadequately controlled hypertension, including high SBPV and/or uncontrolled SBP levels, may be related to increased coronary artery inflammation, HRPs, and OS in T2DM, leading to increased cardiovascular risk. Achieving both low SBPV and controlled SBP levels simultaneously, especially in individuals with T2DM and hypertension, warrants clinical attention.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"102751"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidiabetic combination therapy and cardiovascular outcomes: An evidence-based approach.","authors":"Vanishri Ganakumar, Cornelius J Fernandez, Joseph M Pappachan","doi":"10.4239/wjd.v16.i4.102390","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.102390","url":null,"abstract":"<p><p>Type 2 diabetes mellitus is associated with a 2-4 times increased risk of cardiovascular (CV) disease. Glucagon-like polypeptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) are two important classes of drugs with CV benefits independent of their antihyperglycemic efficacy. The CV outcome trials of both GLP1RA and SGLT2i have demonstrated CV superiority/neutrality concerning major adverse CV events (MACE). While GLP1RAs have exhibited a significant reduction in ischemic stroke and myocardial infarction (MI), SGLT2i have demonstrated a uniformly significant reduction in hospitalization for heart failure (HF) as a class effect. The unique clinical benefits and the distinct but complementary mechanisms of action make the combination of these drugs a mechanistically sound one. Recent meta-analyses suggest an independent and additive benefit of combination therapy of GLP1RA/SGLT2i <i>vs</i> monotherapy. Zhu <i>et al</i>, in a recent issue of the <i>World Journal of Diabetes</i>, demonstrates a numerically lower hazard ratio (HR) for CV outcomes with combination therapy <i>vs</i> monotherapy with either agent, with a reduction in MACE compared to GLP1RA alone [HR = 0.51, 95% confidence interval (CI): 0.16-1.65], or SGLT2i alone (HR = 0.48, 95%CI: 0.15-1.54). The CV death rate was also lower with combination therapy compared to GLP1RA alone (HR = 0.58, 95%CI: 0.08-3.39), or SGLT2i alone (HR = 0.55, 95%CI: 0.07-3.25). Fatal and non-fatal MI and fatal and non-fatal stroke were reduced with combination therapy compared to GLP1RA alone (HR = 0.45, 95%CI: 0.10-2.18 and HR = 0.86, 95%CI: 0.12-6.23, respectively), or SGLT2i alone (HR = 0.44, 95%CI: 0.09-2.10 and HR = 0.74, 95%CI: 0.10-5.47, respectively). Hospitalization for HF was prevented with combination therapy compared to GLP1RA alone (HR = 0.26, 95%CI: 0.03-1.88), or SGLT2i alone (HR = 0.33, 95%CI: 0.04-2.53). They also demonstrated that GLP1RA or SGLT2i monotherapy may not provide significant improvement in CV death and recurrent MI in patients with prior MI or HF, proposing a role for combination therapy in this subgroup. Appropriate patient selection is vital to optimize CV risk reduction as well as the cost-effectiveness of this combination therapy.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"102390"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoglobin glycation index among adults with type 1 diabetes: Association with double diabetes features.","authors":"Xiao-Lin Ji, Min Yin, Chao Deng, Li Fan, Yu-Ting Xie, Fan-Su Huang, Yan Chen, Xia Li","doi":"10.4239/wjd.v16.i4.100917","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.100917","url":null,"abstract":"<p><strong>Background: </strong>The hemoglobin glycation index (HGI) represents the discrepancy between the glucose management indicator (GMI) based on mean blood glucose levels and laboratory values of glycated hemoglobin (HbA1c). The HGI is a promising indicator for identifying individuals with excessive glycosylation, facilitating personalized evaluation and prediction of diabetic complications. However, the factors influencing the HGI in patients with type 1 diabetes (T1D) remain unclear. Autoimmune destruction of pancreatic β cells is central in T1D pathogenesis, yet insulin resistance can also be a feature of patients with T1D and their coexistence is called \"double diabetes\" (DD). However, knowledge regarding the relationship between DD features and the HGI in T1D is limited.</p><p><strong>Aim: </strong>To assess the association between the HGI and DD features in adults with T1D.</p><p><strong>Methods: </strong>A total of 83 patients with T1D were recruited for this cross-sectional study. Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI. DD features included a family history of type 2 diabetes, overweight/obesity/central adiposity, hypertension, atherogenic dyslipidemia, an abnormal percentage of body fat (PBF) and/or visceral fat area (VFA) and decreased estimated insulin sensitivity. Skin autofluorescence of advanced glycation end products (SAF-AGEs), diabetic complications, and DD features were assessed, and their association with the HGI was analyzed.</p><p><strong>Results: </strong>A discrepancy was observed between HbA1c and GMI among patients with T1D and DD. A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy (<i>P</i> = 0.030), particularly retinopathy (<i>P</i> = 0.031). Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI, compared with those without DD features (adjusted odds ratio = 8.12; 95% confidence interval: 1.52-43.47). Specifically, an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI. Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.</p><p><strong>Conclusion: </strong>In patients with T1D, DD features are associated with a higher HGI, which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"100917"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-edged sword of L-arginine in diabetes: Exploring anti-inflammatory and antioxidant strategies.","authors":"Shuai Liu, Ning Li, Jia-Jia Jin, Yong-Wei Yu","doi":"10.4239/wjd.v16.i4.104007","DOIUrl":"https://doi.org/10.4239/wjd.v16.i4.104007","url":null,"abstract":"<p><p>The article by Mansouri <i>et al</i> provides a comprehensive investigation into the effects of L-arginine (L-Arg) on diabetic cardiomyopathy. The authors conclude that while a low dose (0.5 g/kg) of L-Arg improves lipid profiles and reduces body weight, higher doses (≥ 1 g/kg) exacerbate oxidative stress, inflammation, and myocardial damage. In this letter, we aim to expand on the potential role of anti-inflammatory and antioxidant strategies in mitigating these adverse effects. Specifically, we focus on nuclear factor erythroid 2-related factor 2 activation and nitric oxide synthase modulation. These strategies could enhance the clinical utility of L-Arg by preserving its metabolic benefits while reducing its cardiotoxic risks. We believe this perspective will stimulate future research on L-Arg-based therapies in patients with diabetes, with an emphasis on optimizing dosage and exploring synergistic co-therapies.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 4","pages":"104007"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}