World Journal of Diabetes最新文献

{"title":"Increased tumor necrosis factor-receptor superfamily plasma levels are associated with early renal or retinal involvement in intermediate hyperglycemia.","authors":"Sebastian Mas-Fontao, Esther Civantos, Nisa Boukichou-Abdelkader, Juan Antonio Moreno, Carmen Gomez-Guerrero, M Isabel López Gálvez, Jaakko Tuomilehto, Marcus Lind, Rafael Gabriel, Jesús Egido","doi":"10.4239/wjd.v16.i9.106002","DOIUrl":"10.4239/wjd.v16.i9.106002","url":null,"abstract":"<p><strong>Background: </strong>Diabetes and its associated microvascular complications, such as nephropathy and retinopathy, significantly impact global health. These complications often begin in the prediabetic stage, emphasizing the importance of early detection and intervention. Inflammatory pathways are key contributors to these conditions, and recent research has identified members of the tumor necrosis factor (TNF) receptor superfamily as potential biomarkers. However, their association with renal and retinal dysfunction in individuals with intermediate hyperglycemia (IH) remains underexplored. The Early Prevention of Diabetes Complications (ePREDICE) trial provides a valuable cohort to investigate these associations and improve risk assessment strategies.</p><p><strong>Aim: </strong>To identify inflammatory biomarkers associated with early renal and retinal dysfunction in individuals with IH. Specifically, we evaluate the diagnostic and prognostic potential of TNF receptor superfamily members [TNF receptor 1 (TNF-R1), TNF receptor 2 (TNF-R2)], T-cell immunoglobulin and mucin domain 3 (TIM-3)/<i>HAVCR2</i>, galectin-3, and interleukin-6 (IL-6) in detecting kidney dysfunction and retinopathy in this high-risk population. By understanding their roles, we seek to enhance early screening methods and inform personalized intervention strategies.</p><p><strong>Methods: </strong>A cross-sectional analysis of 967 individuals with IH from the ePREDICE trial was conducted. Participants underwent comprehensive anthropometric and biochemical assessments. Key inflammatory biomarkers, including TNF-R1, TNF-R2, TIM-3/<i>HAVCR2</i>, galectin-3, and IL-6, were quantified using immunoassays. Renal function was assessed using estimated glomerular filtration rate (eGFR) and albuminuria, while retinopathy was evaluated through fundoscopic examination. Statistical analyses included adjusted mean comparisons, correlation studies, and receiver operating characteristic curve analysis to assess biomarker diagnostic accuracy.</p><p><strong>Results: </strong>TNF-R1, TNF-R2, and TIM-3/<i>HAVCR2</i> were significantly associated with reduced filtration function (eGFR < 60 mL/minute/1.73 m<sup>2</sup>) and albuminuria, with area under the curve (AUC) values between 0.815 and 0.845. TIM-3/<i>HAVCR2</i> emerged as the strongest predictor of retinopathy (AUC = 0.737). Strong correlations (<i>r</i> > 0.75) were observed among TNF-R1, TNF-R2, and TIM-3/<i>HAVCR2</i>, suggesting a coordinated role in inflammatory pathways.</p><p><strong>Conclusion: </strong>Our findings highlight the potential of TNF receptor superfamily members as biomarkers for early-stage renal and retinal complications in individuals with IH. Their integration into clinical screening protocols could facilitate earlier detection, improving patient stratification and personalized management strategies. Further longitudinal studies are necessary to validate their predictive value and potential for guiding the","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"106002"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114569","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":"Farrerol ameliorates diabetic cardiomyopathy by inhibiting ferroptosis <i>via</i> miR-29b-3p/SIRT1 signaling pathway in endothelial cells.","authors":"Yan Guo, Xin-Rou Yu, Hao-Di Gu, Yu-Jie Wang, Zhen-Gang Yang, Ju-Fang Chi, Liu-Ping Zhang, Hui Lin","doi":"10.4239/wjd.v16.i9.109553","DOIUrl":"10.4239/wjd.v16.i9.109553","url":null,"abstract":"<p><strong>Background: </strong>Diabetic cardiomyopathy (DCM) is the leading cause of cardiovascular disease-related mortality. Farrerol (FA) possesses anti-inflammatory and antioxidant properties. However, its role in regulating endothelial ferroptosis in DCM remains unknown.</p><p><strong>Aim: </strong>To investigate the beneficial effects of FA on cardiac microvascular dysfunction in DCM from the perspective of ferroptosis in endothelial cells (ECs).</p><p><strong>Methods: </strong>The mice were fed a high-fat diet and injected with streptozotocin to induce DCM. DCM mice were orally administered FA (10 and 40 mg/kg/day) and a tail vein injection of the miR-29b-3p mimic or inhibitor for 24 weeks. Cardiac function and myocardial fibrosis were also analyzed. Cardiac microvascular function was assessed using immunofluorescence and transmission electron microscopy. Ferroptosis was analyzed using RNA sequencing, immunofluorescence, and western blotting.</p><p><strong>Results: </strong>FA administration improved cardiac function, alleviated myocardial fibrosis, strengthened endothelial barrier function, suppressed endothelial inflammation, and preserved the microvascular structure in DCM mice. This improvement was associated with the inhibition of endothelial ferroptosis and downregulation of miR-29b-3p in ECs. Similar efficacy was observed after tail vein injection of the miR-29b-3p inhibitor. Inhibition of miR-29b-3p <i>in vivo</i> showed an anti-cardiac fibrotic effect by improving microvascular dysfunction and ferroptosis in ECs, whereas overexpression of miR-29b-3p showed the opposite effects in DCM mice. Luciferase reporter assay revealed that miR-29b-3p binds to SIRT1. In cultured ECs, FA reduced high glucose and free fatty acid (HG/FFA)-induced lipid peroxidation and ferroptosis and inhibited endothelial-mediated inflammation. However, the overexpression of miR-29b-3p partially abolished the protective effects of FA against HG/FFA-induced injury in ECs. This finding suggests that the mechanism of action of FA in improving DCM is related to the downregulation of miR-29b-3p and activation of SIRT1 expression.</p><p><strong>Conclusion: </strong>Therefore, FA has a potential therapeutic effect on cardiac microvascular dysfunction by suppressing EC ferroptosis through the miR-29b-3p/SIRT1 axis.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109553"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114576","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":"Macrophage and inflammation in diabetes and metabolic dysfunction-associated steatotic liver disease: From mechanisms to therapeutic strategies.","authors":"Chun-Ye Zhang, Shuai Liu, Ming Yang","doi":"10.4239/wjd.v16.i9.110515","DOIUrl":"10.4239/wjd.v16.i9.110515","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is featured by the accumulation of excessive fat in the liver. It is caused by many factors, such as overweight, obesity, diabetes, and high plasma levels of sugar, cholesterol, and triglycerides. MASLD is commonly associated with type 2 diabetes (T2D), which is characterized by a pathophysiological deficiency of insulin secretion due to impaired function of pancreatic β cells and insulin resistance. T2D has become a global pandemic that influences more than 21.7 million people worldwide. Pre-clinical and clinical studies have been performed to investigate molecular crosslinks between T2D and MASLD and their therapeutic strategies. Accumulating evidence has demonstrated that macrophages are cellular mediators that contribute to the progression of MASLD and T2D by impacting the resolution of inflammation. Different types of macrophages are involved in the pathogenesis of MASLD and T2D, including liver-resident macrophages or Kupffer cells, monocyte-derived macrophages, and adipose tissue macrophages. These macrophages secrete enzymes, chemokines, cytokines, as well as exosomes, to induce metabolic inflammation and insulin resistance, immune cell infiltration, and tissue injury. In this review, we provide a comprehensive summary of the molecular and cellular interactions between MASLD and T2D with a specific discussion of the critical roles of macrophages and inflammation. The underlying molecular mechanisms and the associated therapeutic targets and strategies are also reviewed.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"110515"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114584","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":"Development and validation of a hypoglycemia risk prediction tool for hospitalized patients with type 2 diabetes mellitus treated with insulin.","authors":"Yao Zhang, Xi-Ling Hu, Wei-Ran Xu, Yan-Ming Chen, Xiao-Di Guo, Shu-Hong Liu, Ling-Ling Gao","doi":"10.4239/wjd.v16.i9.104290","DOIUrl":"10.4239/wjd.v16.i9.104290","url":null,"abstract":"<p><strong>Background: </strong>Insulin is the preferred clinical treatment for hospitalized patients with type 2 diabetes mellitus (T2DM) to control blood glucose effectively. Hypoglycemia is one of the most common adverse events. Accurate prediction of the risk of hypoglycemia is critical in reducing hypoglycemic events and related adverse events in hospitalized diabetic patients treated with insulin.</p><p><strong>Aim: </strong>To develop and validate a hypoglycemia risk prediction tool for hospitalized patients with T2DM treated with insulin.</p><p><strong>Methods: </strong>This retrospective study included 802 hospitalized patients with T2DM in the Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, between January 2021 and December 2021. The hypoglycemia risk prediction model was developed using logistic regression and nomogram models. The model was validated and calibrated using receiver operating characteristic curves and the Hosmer-Lemeshow goodness of fit test.</p><p><strong>Results: </strong>The incidence of hypoglycemia among the enrolled patients was 44.9%. The hypoglycemic risk prediction model included six predictors: Body mass index, duration of diabetes, history of hypoglycemia within 1 year, glomerular filtration rate, blood triglyceride levels, and duration of treatment. The hypoglycemia risk prediction model displayed high discrimination ability (area under the curve = 0.67) and good calibration power (goodness of fit, <i>χ</i> ² =12.25, <i>P</i> = 0.14).</p><p><strong>Conclusion: </strong>The hypoglycemia risk prediction model for hospitalized patients with T2DM on insulin therapy displayed high reliability and discrimination ability. The model is a promising tool for clinicians to screen hospitalized patients with T2DM and an elevated risk of hypoglycemia and guide personalized interventions to prevent and treat hypoglycemia.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"104290"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114735","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":"Type 2 diabetes mellitus: Isn't it time to update the terminology?","authors":"Arkiath Veettil Raveendran","doi":"10.4239/wjd.v16.i9.107517","DOIUrl":"10.4239/wjd.v16.i9.107517","url":null,"abstract":"<p><p>There is a paradigm shift in the approach to the treatment of type 2 diabetes mellitus (T2DM) based on recent research. \"Twin cycle hypothesis\" and remission of diabetes proved that diabetes is a disease due to excess fat accumulation above the personal fat threshold. Hence, weight reduction and, whenever possible, achievement of remission has become therapeutic target for the management of T2DM. Increasing evidence suggests that T2DM is a part of the spectrum of diseases caused by excess fat accumulation. Hence, it indeed is the need of the hour to update the terminologies to indicate that T2DM is part of the disease spectrum of excess fat accumulation to improve awareness among healthcare professionals and the public to achieve overall holistic management of the disease spectrum. In this short article, we analyze these factors and propose a new terminology for adaptation worldwide.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"107517"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114775","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":"Managing diabetic ketoacidosis in special conditions: Difficulties and dilemmas.","authors":"Sayantan Ray, Rajan Palui","doi":"10.4239/wjd.v16.i9.109053","DOIUrl":"10.4239/wjd.v16.i9.109053","url":null,"abstract":"<p><p>The management of diabetic ketoacidosis can be challenging in high-risk patients. Recent studies have reported a significant increase in diabetic ketoacidosis hospitalization rates. While managing this high-risk condition, patient factors and comorbidities should be given careful attention and consideration. Factors like pregnancy, renal disease, cardiac disease, older age, and use of sodium-glucose cotransporter-2 inhibitors all impact the treatment approach, and tailored management strategies are required. Particularly in children, specialized treatment and care during a diabetic ketoacidosis episode is necessary due to its long-term neurological consequences. However, guidelines often lack adequate recommendations about the approach to manage complex patients with specific conditions and comorbidities. Furthermore, there are still controversies around certain aspects of diabetic ketoacidosis management, and additional investigations are needed to determine the best management options. We aim to address these special conditions and provide an approach to manage complex patients with specific conditions and co-morbidities.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109053"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114689","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":"Postprandial C-peptide is more relevant to hemoglobin A1c levels and diabetic microvascular complications than fasting C-peptide in type 2 diabetes.","authors":"Zheng Wang, Ming-Qun Deng, Li-Xin Guo, Qi Pan","doi":"10.4239/wjd.v16.i9.109414","DOIUrl":"10.4239/wjd.v16.i9.109414","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM), driven by insulin resistance and β cell dysfunction, necessitates reliable assessment of β cell function. C-peptide (CP) measurement, a stable marker of endogenous insulin secretion, is useful for this clinically as it avoids interference from exogenous insulin. While fasting CP (FCP) and postprandial CP (PCP), along with glucose-adjusted indices and ratios, such as FCP/fasting plasma glucose (FPG), 2 hours postprandial CP (2hCP)/postprandial blood glucose (PBG) and CP ratio, are used, their comparative efficacy in reflecting β cell function remains unclear. Hemoglobin A1c (HbA1c), a key glycemic control indicator, theoretically links β cell function to complications, but limited studies have explored the associations between diverse CP indices, HbA1c, and diabetic microvascular complications.</p><p><strong>Aim: </strong>To investigate the relationships between different CP indices and HbA1c as well as diabetic microvascular complications in T2DM.</p><p><strong>Methods: </strong>T2DM patients admitted to Department of Endocrinology at Beijing Hospital between July 1, 2021 and December 31, 2021 were included in the study. Clinical and laboratory data were collected, including CP levels, glucose levels, HbA1c levels and diabetic microvascular complications. Statistical analysis was performed using Statistical Package for the Social Sciences 24.0.</p><p><strong>Results: </strong>A total of 453 patients were included in the final analysis. Adjusted by confounding factors, CP ratio and CP/blood glucose (BG) ratio were not relevant to HbA1c, but FCP, 2hCP, delta CP, FCP/FPG, 2hCP/PBG and delta CP/BG were still negatively correlated to HbA1c_, of which 2hCP/PBG showed the strongest negative correlation (<i>r</i> = -0.485, <i>P</i> < 0.001). Independent of HbA1c and other confounding factors, 2hCP, 2hCP/PBG, delta CP and delta CP/BG were protective factors of diabetic retinopathy while 2hCP, delta CP and FCP/FPG were protective factors of diabetic peripheral neuropathy.</p><p><strong>Conclusion: </strong>This study indicates that higher levels of CP indices suggest better glucose control and a lower prevalence of diabetic microvascular complications, and PCP indices, particularly 2hCP/PBG, were more relevant to HbA1c and diabetic microvascular complications than FCP indices. These results suggest CP-related indices could be useful biomarkers for diabetes management, warranting further research.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"109414"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114725","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":"Diabetic gastrointestinal autonomic neuropathy: Integrating neuronal degeneration and gut microbial dysbiosis.","authors":"Mei-Xia Zhou, Yu Zhao, Chen-Ling Chu, Tapas Ranjan Behera, Quan-Quan Shen, Yu-Bo Xing","doi":"10.4239/wjd.v16.i9.110053","DOIUrl":"10.4239/wjd.v16.i9.110053","url":null,"abstract":"<p><p>Diabetic gastrointestinal autonomic neuropathy (DGAN) is a common and debilitating complication of diabetes, characterized by autonomic dysfunction in the gastrointestinal system. The complex pathophysiology of DGAN involves neuronal injury that is intrinsically linked to gut dysbiosis. Multiple factors, including hyperglycemia, oxidative stress, and inflammation, significantly contribute to neuronal damage, manifesting as symptoms such as delayed gastric emptying, diarrhea, and constipation. Recent studies have demonstrated that patients with diabetes experience substantial alterations in gut microbiota composition, potentially exacerbating gastrointestinal symptoms. Microbial metabolites may modulate neurotransmitter synthesis and release, directly affecting autonomic nerve function, while dysbiosis amplifies oxidative stress and inflammation, further compromising the enteric nervous system and worsening DGAN. Advances in multi-omics technologies now provide deeper insights into molecular mechanisms of DGAN and its interactions with microbiota. Early diagnosis leveraging biomarkers, gut microbiota analysis, and advanced imaging promises more effective interventions. Emerging therapeutic strategies targeting oxidative stress, inflammation, and gut microbiota represent promising approaches for managing DGAN. Future research should focus on large-scale, multi-ethnic studies and therapies targeting specific microbial metabolites to refine diagnosis and treatment approaches.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"110053"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114447","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":"Spatial transcriptomics meets diabetic kidney disease: Illuminating the path to precision medicine.","authors":"Dan-Dan Liu, Han-Yue Hu, Fei-Fei Li, Qiu-Yue Hu, Ming-Wei Liu, You-Jin Hao, Bo Li","doi":"10.4239/wjd.v16.i9.107663","DOIUrl":"10.4239/wjd.v16.i9.107663","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD), a primary cause of end-stage renal disease, results from progressive tissue remodeling and loss of kidney function. While single-cell RNA sequencing has significantly accelerated our understanding of cellular diversity and dynamics in DKD, its lack of spatial resolution limits insights into tissue-specific dysregulation and the microenvironment. Spatial transcriptomics (ST) is an innovative technology that combines gene expression with spatial localization, offering a powerful approach to dissect the molecular mechanisms of DKD. This mini-review introduces how ST has transformed DKD research by enabling spatially resolved analysis of cell interactions and identifying localized molecular alterations in glomeruli and tubules. ST has revealed dynamic intercellular communication within the renal microenvironment, lesion-specific gene expression patterns, and immune infiltration profiles. For example, Slide-seqV2 has highlighted disease-specific cellular neighborhoods and associated signaling networks. Furthermore, ST has pinpointed key genes implicated in disease progression, such as fibrosis-related proteins and transcription factors in tubular damage. By integration of ST with computational tools such as machine learning and network-based analysis can help uncover gene regulatory mechanisms and potential therapeutic targets. However, challenges remain in limited spatial resolution, high data complexity, and computational demands. Addressing these limitations is essential for advancing precision medicine in DKD.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"107663"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114765","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":"Exploring the relationship between health knowledge, health literacy, self-care, self-efficacy, and glycemic control among adults with type 2 diabetes mellitus.","authors":"Sasikala D Amirthalingam, Malanashita Ganeson, Chandramani Thuraisingham, Verna K M Lee, Chun Wai Chan, Lokman H Sulaiman, Sivarajan Ramasamy, Mohamad A Bujang, Cheong Lieng Teng","doi":"10.4239/wjd.v16.i9.105138","DOIUrl":"10.4239/wjd.v16.i9.105138","url":null,"abstract":"<p><strong>Background: </strong>Adults with type 2 diabetes mellitus (T2DM) in Malaysia continue to have substantial comorbidities and struggle to achieve glycemic targets.</p><p><strong>Aim: </strong>To comprehensively evaluate diabetes self-care and glycemic control using multiple self-reporting questionnaires.</p><p><strong>Methods: </strong>Adults diagnosed with T2DM attending the Seremban Health Clinic were recruited in this cross-sectional study. Eligible participants were recruited based on a consecutive sampling technique, first-come-first-served-basis if they fulfilled the inclusion and exclusion criteria. In addition to the usual sociodemographic, clinical, and laboratory data, the participants answered seven specific self-reporting questionnaires. This report was focused on six key variables: Glycemic control; self-care; self-efficacy; diabetes knowledge; health literacy; and medication adherence.</p><p><strong>Results: </strong>A total of 100 adults with T2DM participated. The proportions of participants achieving specific thresholds in the key variables were: Acceptable glycemic control 39.4%; adequate diabetes knowledge 59.6%; sufficient or higher health literacy 80.2%; and medication adherence 51.0%. The mean self-efficacy score was 110.6 (73.3% of maximum), and the mean self-care score was 30.7 (43.9% of maximum). A statistically significant linear correlation was observed for eight pairs of key variables with Pearson's correlation values varying between 0.21 to 0.55. Self-efficacy had a relatively higher correlation while glycated hemoglobin was not correlated with other key variables. Path analysis was conducted to examine the relationships among diabetes self-efficacy (Diabetes Management Self Efficacy scale score), self-care behavior (Summary of Diabetes Self-Care Activities score), and glycemic control, but the model demonstrated a poor fit (<i>χ</i>² = 28.1, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>We found substantial suboptimal glycemic control and low self-care practices but acceptable levels of diabetes knowledge, self-efficacy, health literacy and medication adherence among the patients with T2DM. In spite of the correlations between self-care, self-efficacy, and medication adherence, it was surprising that self-care did not correlate with glycemic control. Prospective cohort studies are needed to explore whether these factors influence diabetes outcomes.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 9","pages":"105138"},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114506","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}