World Journal of Diabetes最新文献

{"title":"Sarcopenia-associated factors and their bone mineral density levels in middle-aged and elderly male type 2 diabetes patients.","authors":"De-Qing Chen, Yong-Xin Wu, Ying-Xiao Zhang, Hai-Ling Yang, Huan-Huan Huang, Jiang-Yan Lv, Qian Xiao","doi":"10.4239/wjd.v15.i12.2285","DOIUrl":"10.4239/wjd.v15.i12.2285","url":null,"abstract":"<p><strong>Background: </strong>Chronic hyperglycemia can damage the microcirculation, which impairs the function of various organs and tissues and predisposes individuals to chronic complications. Sarcopenia (SP) is the age-related decline in muscle mass and function that contributes to the sequelae of type 2 diabetes. In particular, diabetic patients are at higher risk of SP because of insulin resistance, chronic inflammation, and decreased physical activity.</p><p><strong>Aim: </strong>To identify SP-associated factors in middle-aged and elderly male type 2 diabetes mellitus (T2DM) patients and their correlation with bone mineral density (BMD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 196 middle-aged and elderly male T2DM inpatients in the First Affiliated Hospital of Chongqing Medical University between June 2021 and June 2023, with 60 concurrent healthy individuals as the control group. Differences in general information, blood biochemistry, glycosylated hemoglobin, muscle strength, and detection rate of SP were compared between groups. The BMD, appendicular skeletal muscle (ASM), and fat mass, as well as grip strength and gait speed, were determined for each patient, and the ASM index (ASMI) was counted. The quantitative data were subjected to correlation and logistic regression analyses to identify risk factors for SP.</p><p><strong>Results: </strong>Fifty-one of the 196 middle-aged and elderly male T2DM patients were diagnosed with SP, which accounted for 26.02%. The middle-aged and elderly T2DM patients with SP exhibited a longer diabetes mellitus (DM) course and a lower body mass index (BMI) and 25(OH)D₃ compared with the non-SP patients. The T2DM + SP patients exhibited lower BMI, ASM, ASMI, left- and right-hand grip strength, gait speed, and muscle and fat mass of the upper and lower limbs compared with the diabetic non-SP patients. The femoral neck, total hip, and lumbar spine L_1-4 BMD were markedly lower in T2DM + SP patients compared with those in the non-SP diabetics. Long-term DM course, low BMI, and low BMD of the femoral neck, lumbar spine L_1-4, and total hip were identified as risk factors for the development of SP.</p><p><strong>Conclusion: </strong>T2DM patients are at risk for SP; however, measures can be taken to prevent the related risk factors.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2285-2292"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829968","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":"Shikonin protects mitochondria through the NFAT5/AMPK pathway for the treatment of diabetic wounds.","authors":"Lu-Sha Cen, Yi Cao, Yi-Mai Zhou, Jing Guo, Jing-Wen Xue","doi":"10.4239/wjd.v15.i12.2338","DOIUrl":"10.4239/wjd.v15.i12.2338","url":null,"abstract":"<p><strong>Background: </strong>Shikonin is a natural remedy that is effective at treating diabetic wounds. NFAT5 is a potential therapeutic target for diabetes, and mitochondrial function is essential for wound healing. However, the relationship among Shikonin, NFAT5, and mitochondrial function has not been thoroughly studied. Here, we offer new perspectives on the advantages of shikonin for managing diabetes.</p><p><strong>Aim: </strong>To assess the therapeutic mechanism of shikonin in diabetic wounds, its relationship with NFAT5, and its protection of mitochondrial function.</p><p><strong>Methods: </strong>Hypertonic cell and diabetic wound mouse models were established. NFAT5 expression was measured through western blotting and immunofluorescence, <i>in vivo</i> and <i>in vitro</i>. Mitochondrial function was evaluated using reactive oxygen species (ROS) detection and JC-1 and Calcein AM dyes. Mitochondrial structures were observed using transmission electron microscopy. The NFAT5/AMPK pathway was analyzed using a transfection vector and an inhibitor. The effect of shikonin on cells under hypertonic conditions <i>via</i> the NFAT5/AMPK pathway was assessed using western blotting.</p><p><strong>Results: </strong>Shikonin treatment preserved HaCaT cell viability, while significantly reducing cyclooxygenase-2 expression levels in a high-glucose environment (<i>P</i> < 0.05). Additionally, shikonin maintained mitochondrial morphology, enhanced membrane potential, reduced membrane permeability, and decreased ROS levels in HaCaT cells under hyperosmolar stress. Furthermore, shikonin promoted wound healing in diabetic mice (<i>P</i> < 0.05). Shikonin also inhibited NFAT5, <i>in vivo</i> and <i>in vitro</i> (<i>P</i> < 0.05). Shikonin treatment reduced NFAT5 expression levels, subsequently inhibiting AMPK expression <i>in vitro</i> (<i>P</i> < 0.05). Finally, shikonin inhibited several key downstream molecules of the NFAT5/AMPK pathway, including mammalian target of rapamycin, protein kinase B, nuclear factor kappa-light-chain-enhancer of activated B cells, and inducible nitric oxide synthase (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Shikonin protects mitochondria <i>via</i> the NFAT5/AMPK-related pathway and enhances wound healing in diabetes.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2338-2352"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830279","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":"Peroxisome proliferator-activated receptor gamma mutation in familial partial lipodystrophy type three: A case report and review of literature.","authors":"Chao-Jun Wu, Hao Liu, Li-Juan Tu, Jiong-Yu Hu","doi":"10.4239/wjd.v15.i12.2360","DOIUrl":"10.4239/wjd.v15.i12.2360","url":null,"abstract":"<p><strong>Background: </strong>Familial partial lipodystrophy disease (FPLD) is a collection of rare genetic diseases featuring partial loss of adipose tissue. However, metabolic difficulties, such as severe insulin resistance, diabetes, hypertriglyceridemia, and hypertension frequently occur alongside adipose tissue loss, making it susceptible to misdiagnosis and delaying effective treatment. Numerous genes are implicated in the occurrence of FPLD, and genetic testing has been for conditions linked to single gene mutation related to FPLD. Reviewing recent reports, treatment of the disease is limited to preventing and improving complications in patients.</p><p><strong>Case summary: </strong>In 2017, a 31-year-old woman with diabetes, hypertension and hypertriglyceridemia was hospitalized. We identified a mutation in her peroxisome proliferator-activated receptor gamma (<i>PPARG</i>) gene, Y151C (p.Tyr151Cys), which results in a nucleotide substitution residue 452 in the DNA-binding domain (DBD) of <i>PPARG</i>. The unaffected family member did not carry this mutation. Pioglitazone, a <i>PPARG</i> agonist, improved the patient's responsiveness to hypoglycemic and antihypertensive therapy. After one year of treatment in our hospital, the fasting blood glucose and glycosylated hemoglobin of the patient were close to normal.</p><p><strong>Conclusion: </strong>We report a rare <i>PPARG</i> mutation, Y151C, which is located in the DBD of <i>PPARG</i> and leads to FPLD, and the preferred agent is <i>PPARG</i> agonists. We then summarized clinical phenotypic characteristics of FPLD3 caused by <i>PPARG</i> gene mutations, and clarified the relationship between different mutations of <i>PPARG</i> gene and the clinical manifestations of this type of FPLD. Additionally, current treatments for FPLD caused by <i>PPARG</i> mutations are reviewed.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2360-2369"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830596","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":"Application value of high-pressure-resistant peripherally inserted central catheters in enhanced computer tomography of diabetic patients with malignant tumors.","authors":"Li Zhang, Hui-Feng Yan","doi":"10.4239/wjd.v15.i12.2293","DOIUrl":"10.4239/wjd.v15.i12.2293","url":null,"abstract":"<p><strong>Background: </strong>Individuals with diabetes mellitus have a higher risk of developing malignant tumors, and diagnosing these tumors can be challenging.</p><p><strong>Aim: </strong>To confirm the benefits of using peripherally inserted central catheters (PICCs) in contrast-enhanced computerized tomography (CECT) for diagnostic imaging in diabetic patients with malignant tumors and to provide a research basis for follow-up research.</p><p><strong>Methods: </strong>This retrospective study analyzed 204 diabetic patients with malignancies treated at The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, from January 2024 to June 2024. The patients were divided into two groups: A control group (<i>n</i> = 102) with indwelling peripheral intravenous catheters and a research group (<i>n</i> = 102) with high-pressure-resistant PICC. The study compared baseline data, the incidence of iodine contrast extravasation during CECT, the incidence of adverse events (discomfort, redness and swelling at the puncture site, and blood oozing), imaging quality, nursing time, intubation success rate, number of venipuncture attempts, and catheter maintenance cost.</p><p><strong>Results: </strong>Male patients accounted for 51.96% in the control group and 55.88% in the research group; the average age was (59.68 ± 11.82) years in the control group and (61.41 ± 12.92) years in the research group; the proportions of lung cancer, colorectal cancer, and gastric cancer patients in the control group were 42.16%, 38.24%, and 19.61%, respectively, while those in the research group were 34.31%, 37.25%, and 28.43%, respectively. Except for the gender distribution, age, and cancer type mentioned above, other general information such as underlying diseases, puncture location, and long-term chemotherapy shows no significant differences as tested (<i>P</i> > 0.05). The results showed that the research group had significantly reduced incidence of iodine contrast extravasation (7 <i>vs</i> 1, <i>P</i> = 0.031), similar incidence of adverse events (11 <i>vs</i> 7, <i>P</i> = 0.324), reduced nursing time [(18.50 ± 2.68) minutes <i>vs</i> (13.26 ± 3.00) minutes, <i>P</i> = 0.000], fewer venipuncture attempts [(2.21 ± 0.78) times <i>vs</i> (1.49 ± 0.58) times, <i>P</i> = 0.000], lower catheter maintenance cost [(1251.79 ± 205.47) China yuan (CNY) <i>vs</i> (1019.25 ± 117.28) CNY, <i>P</i> = 0.000], increased intubation success rate (16.67% <i>vs</i> 58.82%, <i>P</i> = 0.000), and better imaging quality (85.29% <i>vs</i> 94.12%, <i>P</i> = 0.038).</p><p><strong>Conclusion: </strong>High-pressure-resistant PICCs can lessen the physical burden of diabetic patients during nursing, reduce treatment costs, and improve the efficiency and quality of imaging for diagnosis malignant tumors.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2293-2301"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830569","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":"Insights into glymphatic system dysfunction and glucose continuum.","authors":"Tsvetelina Velikova, Georgi Vasilev","doi":"10.4239/wjd.v15.i12.2404","DOIUrl":"10.4239/wjd.v15.i12.2404","url":null,"abstract":"<p><p>In this article, we comment on an original article published in a recent issue of the <i>World Journal of Diabetes</i>. That observational cross-sectional study focused on investigating the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states by using diffusion tensor imaging along the perivascular space (DTI-ALPS) index. It was shown that the cerebral glymphatic system may be dysfunctional in patients with type 2 diabetes. Various clinical variables affected the DTI-ALPS index in different glucose metabolism states. In conclusion, the study by Tian <i>et al</i> improves the understanding of the pathophysiology of diabetes-associated brain damage and provides insights for early diagnosis.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2404-2408"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830588","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":"Promise of the gut microbiota in prevention and traditional Chinese medicine treatment of diabetic peripheral neuropathy.","authors":"Yuan-Hao Cao, Yi-Mai Zhou, Si-Yu Wang, Jing Guo, Lu-Sha Cen","doi":"10.4239/wjd.v15.i12.2387","DOIUrl":"10.4239/wjd.v15.i12.2387","url":null,"abstract":"<p><p>The pathogenesis of diabetic peripheral neuropathy (DPN) has not been fully elucidated, and treatment options are limited. Currently, the main strategies for treating DPN are strict glycemic control and symptomatic pain relief. In this editorial, we comment on an article by Li <i>et al,</i> which suggested that modulating the gut microbiota using traditional Chinese medicine (TCM) may be a promising strategy for alleviating DPN symptoms. The regulation of the gut microbiota has received widespread attention in the study of various diseases. TCM can participate in the regulation of gut microbiota through multiple mechanisms, and this regulatory effect can alleviate the clinical symptoms of DPN. We briefly analyzed the promise of the gut microbiota in the early diagnosis, treatment, and clinical efficacy of TCM for DPN. The gut microbiota has potential value at multiple nodes in the occurrence and progression of DPN.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2387-2393"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830598","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":"Screening and evaluation of diabetic retinopathy <i>via</i> a deep learning network model: A prospective study.","authors":"Li Yao, Chan-Yuan Cao, Guo-Xiao Yu, Xu-Peng Shu, Xiao-Nan Fan, Yi-Fan Zhang","doi":"10.4239/wjd.v15.i12.2302","DOIUrl":"10.4239/wjd.v15.i12.2302","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is one of the most common serious complications in diabetic patients, and early screening and diagnosis are essential to prevent visual impairment. With the rapid development of deep learning technology, network models based on attention mechanisms have shown significant advantages in medical image analysis, which can improve the accuracy and efficiency of screening.</p><p><strong>Aim: </strong>To evaluate the efficacy of an attention mechanism-based deep learning network model in screening for DR in natural and diabetic populations, as well as in screening with unilateral and bilateral fundus photography.</p><p><strong>Methods: </strong>From January 2023 to June 2024, a stratified multistage cluster sampling method was adopted to select a representative sample of permanent residents aged 18-70 years from our hospital. A total of 948 fundus images from 474 participants were included in the \"deep learning model\" system for scoring. The fundus images were graded <i>via</i> the early treatment of DR [Early Treatment Diabetic Retinopathy Study (ETDRS)] scoring system as the gold standard for the diagnosis of DR. With \"DR to be referred (ETDRS > 31)\" as the reference variable, a receiver operating characteristic curve was drawn to evaluate the area under the curve (AUC), sensitivity and specificity of the \"deep learning model\" to determine the screening efficiency of the system.</p><p><strong>Results: </strong>For each subject, in the natural population, the AUC of using the \"deep learning model system\" to screen \"DR-requiring referral\" was 0.941, and the sensitivity and specificity were 98.15% and 90.08%, respectively. The sensitivity and specificity of two-directional fundus photography were 100% and 86.91%, respectively. In the diabetic population, the AUC, sensitivity and specificity were 0.901, 98.08% and 82.10%, respectively, when \"wise eye sugar net\" unilateral fundus photography was used to screen for \"DR-requiring referrals\".</p><p><strong>Conclusion: </strong>In both the natural population and the diabetic population, the deep learning model system has shown high sensitivity and specificity and can be used as an auxiliary means of DR screening.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2302-2310"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830296","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":"Relevance of macrophages in the wound healing process among individuals afflicted with diabetic foot ulcers.","authors":"Li-Hong Chen, Xing-Wu Ran","doi":"10.4239/wjd.v15.i12.2384","DOIUrl":"10.4239/wjd.v15.i12.2384","url":null,"abstract":"<p><p>In this paper, we provide a commentary on an article focusing on diabetic foot ulcer (DFU) as a dreadful complication of diabetes mellitus. The development of this condition is influenced by factors such as diabetic peripheral neuropathy, lower extremity artery disease, and infection. However, the underlying mechanism remains elusive. Macrophages play a critical role in wound healing processes, suggesting that therapies targeting these cells could potentially improve the management of DFU. A comprehensive understanding of developmental trends of macrophages within the field of DFU may facilitate research advancements and the development of novel treatment strategies.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 12","pages":"2384-2386"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830600","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 exercise during pregnancy on offspring development through ameliorating high glucose and hypoxia in gestational diabetes mellitus.","authors":"Yi-Bo Tang, Le-Sha Wang, Yi-Hui Wu, Li-Xia Zhang, Lu-Yao Hu, Qi Wu, Meng-Lin Zhou, Zhao-Xia Liang","doi":"10.4239/wjd.v15.i11.2203","DOIUrl":"10.4239/wjd.v15.i11.2203","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) women require prenatal care to minimize short- and long-term complications. The mechanism by which exercise during pregnancy affects organ development and whether glucose transporter (GLUT) 1 plays a role in GDM offspring organ development remains unknown.</p><p><strong>Aim: </strong>To determine the effect of exercise during pregnancy on the cardiac, hepatic and renal development of GDM mother's offspring.</p><p><strong>Methods: </strong>Placenta samples were collected from humans and mice. GDM mouse models were created using streptozotocin along with a GDM with exercise group. The hearts, livers and kidneys of 3- and 8-week-old offspring were collected for body composition analysis and staining. The effects of high glucose levels and hypoxia were investigated using HTR8/SVneo. Transwell and wound-healing assays were performed to assess cell migration. Immunofluorescence accompanied with TUNEL and Ki67 staining was used to explore apoptosis and proliferation.</p><p><strong>Results: </strong>Exercise during pregnancy downregulated the GLUT1 and hypoxia inducible factor-1α expression in placenta from individuals with GDM. Cobalt chloride-induced hypoxia and high glucose levels also significantly decreased migration and apoptosis of HTR8/SVneo cells. In addition, exercise reduced inflammatory cell infiltration in the liver and decreased the tubular vacuolar area in the kidneys of offspring.</p><p><strong>Conclusion: </strong>GDM affects the growth and development of organs in offspring. Exercise during pregnancy can reverse adverse effects of GDM on the development of the heart, liver, and kidney in offspring.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 11","pages":"2203-2219"},"PeriodicalIF":4.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711474","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":"Glucagon-like peptide-1 agonists: Role of the gut in hypoglycemia unawareness, and the rationale in type 1 diabetes.","authors":"Hyder O Mirghani","doi":"10.4239/wjd.v15.i11.2167","DOIUrl":"10.4239/wjd.v15.i11.2167","url":null,"abstract":"<p><p>Type 1 diabetes is increasing and the majority of patients have poor glycemic control. Although advanced technology and nanoparticle use have greatly enhanced insulin delivery and glucose monitoring, weight gain and hypoglycemia remain major challenges and a constant source of concern for patients with type 1 diabetes. Type 1 diabetes shares some pathophysiology with type 2 diabetes, and an overlap has been reported. The above observation created great interest in glucagon-like peptide-1 receptor agonists (GLP-1) as adjuvants for type 1 diabetes. Previous trials confirmed the positive influence of GLP-1 agonists on β cell function. However, hypoglycemia unawareness and dysregulated glucagon response have been previously reported in patients with recurrent hypoglycemia using GLP-1 agonists. Jin <i>et al</i> found that the source of glucagon dysregulation due to GLP-1 agonists resides in the gut. Plausible explanations could be gut nervous system dysregulation or gut microbiota disruption. This review evaluates the potential of GLP-1 agonists in managing type 1 diabetes, particularly focusing on their impact on glycemic control, weight management, and glucagon dysregulation. We provide a broader insight into the problem of type 1 diabetes mellitus management in the light of recent findings and provide future research directions.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 11","pages":"2167-2172"},"PeriodicalIF":4.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711557","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}