World Journal of Diabetes最新文献

{"title":"Correlation between key indicators of continuous glucose monitoring and the risk of diabetic foot.","authors":"Xin-Qian Geng, Shun-Fang Chen, Fei-Ying Wang, Hui-Jun Yang, Yun-Li Zhao, Zhang-Rong Xu, Ying Yang","doi":"10.4239/wjd.v16.i3.99277","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.99277","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) metrics, such as time in range (TIR) and glycemic risk index (GRI), have been linked to various diabetes-related complications, including diabetic foot (DF).</p><p><strong>Aim: </strong>To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 591 individuals with T2DM (297 with DF and 294 without DF) were enrolled. Relevant clinical data, complications, comorbidities, hematological parameters, and 72-hour CGM data were collected. Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.</p><p><strong>Results: </strong>Individuals with DF exhibited higher mean blood glucose (MBG) levels and increased proportions of time above range (TAR), TAR level 1, and TAR level 2, but lower TIR (all <i>P</i> < 0.001). Patients with DF had significantly lower rates of achieving target ranges for TIR, TAR, and TAR level 2 than those without DF (all <i>P</i> < 0.05). Logistic regression analysis revealed that GRI, MBG, and TAR level 1 were positively associated with DF risk, while TIR was inversely correlated (all <i>P</i> < 0.05). Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels (<i>P</i> < 0.05). Additionally, achieving TAR was influenced by fasting plasma glucose, body mass index, diabetes duration, and antidiabetic medication use.</p><p><strong>Conclusion: </strong>CGM metrics, particularly TIR and GRI, are significantly associated with the risk of DF in T2DM, emphasizing the importance of improved glucose control.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"99277"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651250","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":"Investigating the impact of intestinal glucagon-like peptide-1 on hypoglycemia in type 1 diabetes.","authors":"Mahmoud Nassar, Angad Singh Gill, Erlin Marte","doi":"10.4239/wjd.v16.i3.99142","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.99142","url":null,"abstract":"<p><p>Recent advances in understanding type 1 diabetes (T1D) highlight the complexity of managing hypoglycemia, a frequent and perilous complication of diabetes therapy. This letter delves into a novel study by Jin <i>et al</i>, which elucidates the role of intestinal glucagon-like peptide-1 (GLP-1) in the counterregulatory response to hypoglycemia in T1D models. The study employed immunofluorescence, Western blotting, and enzyme-linked immunosorbent assay to track changes in GLP-1 and its receptor expression in diabetic mice subjected to recurrent hypoglycemic episodes. Findings indicate a significant increase in intestinal GLP-1 and GLP-1 receptor expression, correlating with diminished adrenal and glucagon responses, crucial for glucose stabilization during hypoglycemic events. This letter aims to explore the implications of these findings for future therapeutic strategies and the broader understanding of T1D management.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"99142"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651466","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":"Optimizing risk management for post-amputation wound complications in diabetic patients: Focus on glycemic and immunosuppressive control.","authors":"Zhi-Peng Li, Jin-Ke Sun, Wei-Ping Fu, Chang-Jiang Zhang","doi":"10.4239/wjd.v16.i3.102899","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.102899","url":null,"abstract":"<p><p>This study highlights the importance of identifying and addressing risk factors associated with wound complications following transtibial amputation in diabetic patients. These amputations, often necessitated by severe diabetic foot ulcers, carry significant risks of postoperative complications such as infection and delayed wound healing. Elevated hemoglobin A1c levels, indicative of poor glycemic control, and a history of kidney transplantation, due to required immunosuppressive therapy, are key factors influencing these outcomes. This paper emphasizes the need for enhanced glycemic management and personalized postoperative care, particularly for immunocompromised individuals, to minimize complications and improve patient prognosis. Future research should focus on prospective studies to validate targeted interventions and optimize care strategies, ultimately aiming to reduce the healthcare burden associated with diabetic foot complications.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"102899"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651488","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":"NR4A1 silencing alleviates high-glucose-stimulated HK-2 cells pyroptosis and fibrosis <i>via</i> hindering NLRP3 activation and PI3K/AKT pathway.","authors":"Jin-Meng Li, Zi-Hua Song, Yuan Li, Han-Wen Chen, Han Li, Lu Yuan, Jing Li, Wen-Yue Lv, Lei Liu, Na Wang","doi":"10.4239/wjd.v16.i3.97544","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.97544","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of diabetic kidney disease (DKD) is complex. Interfering with the processes of pyroptosis and fibrosis is an effective strategy for slowing DKD progression. Previous studies have revealed that nuclear receptor subfamily 4 group A member 1 (NR4A1) may serve as a novel pathogenic element in DKD; however, the specific mechanism by which it contributes to pyroptosis and fibrosis in DKD is unknown.</p><p><strong>Aim: </strong>To investigate the role of NR4A1 in renal pyroptosis and fibrosis in DKD and possible molecular mechanisms.</p><p><strong>Methods: </strong>Streptozotocin 60 mg/kg was injected intraperitoneally to establish a rat model of DKD. Typically, 45 mmol/L glucose [high glucose (HG)] was used to activate HK-2 cells to mimic the DKD model <i>in vitro</i>. HK-2 cells were transfected with NR4A1 siRNA to silence NR4A1.</p><p><strong>Results: </strong>NR4A1 was elevated in renal tissues of DKD rats and HG-stimulated HK-2 cells. Concurrently, NOD-like receptor protein 3 (NLRP3) and phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathways were triggered, and pyroptosis and expression of fibrosis-linked elements was increased <i>in vivo</i> and <i>in vitro</i>. These alterations were significantly reversed <i>via</i> NR4A1 silencing.</p><p><strong>Conclusion: </strong>Inhibition of NR4A1 mitigated pyroptosis and fibrosis <i>via</i> suppressing NLRP3 activation and the PI3K/AKT pathway in HG-activated HK-2 cells.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"97544"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651437","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":"Premixed insulin: Advantages, disadvantages, and future.","authors":"Yan Xia, Yun Hu, Jian-Hua Ma","doi":"10.4239/wjd.v16.i3.102526","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.102526","url":null,"abstract":"<p><p>Premixed insulin combines two types of insulin in a single injection. This combination streamlines dosing for patients with type 1 or type 2 diabetes, thereby enhancing convenience. However, patients receiving premixed insulin commonly have less satisfactory blood glucose control. The fixed ratio of insulin in these formulations frequently fails to account for the nuanced demands of individualized glucose-lowering therapy. Moreover, local absorption of mixed insulin and potential systemic autoimmune responses may further compromise glycaemic control. The co-formulation of insulin degludec and insulin aspart introduces a new combination of the two insulin types within a single injection, offering a promising solution for mitigating the limitations inherent in premixed insulin.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"102526"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651498","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":"Association between high-sensitivity troponin T levels below the ninety-ninth percentile and diabetic kidney disease: A cross-sectional study.","authors":"Xiao-Yan Luo, Li-Hua Huang, Kun-Peng Kang","doi":"10.4239/wjd.v16.i3.99108","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.99108","url":null,"abstract":"<p><strong>Background: </strong>Identification of myocardial injury has traditionally relied on high-sensitivity troponin T (hs-TnT) levels exceeding the 99^th percentile threshold. However, patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.</p><p><strong>Aim: </strong>To investigate the association between hs-TnT levels below the 99^th percentile and the presence of diabetic kidney disease (DKD) in patients with diabetes mellitus.</p><p><strong>Methods: </strong>This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004, focusing on adults with type 2 diabetes mellitus. Serum hs-TnT concentrations were evaluated. DKD was defined as impaired glomerular filtration rate (< 60 mL/minute/1.73 m²), proteinuria (urinary albumin-to-creatinine ratio of ≥ 30 mg/g), or both conditions in patients with diabetes mellitus. Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD, with the likelihood ratio test being used to evaluate nonlinearity.</p><p><strong>Results: </strong>The study included 2505 patients with a mean age of 55.02 (standard error: 0.72) years, of whom 44.87% were females. Among the participants, 909 (32.34%) were diagnosed with DKD. Multivariable logistic regression analysis indicated that, compared to the lowest tertile of hs-TnT (< 5.93 ng/L), tertile 2 (5.94-9.79 ng/L) had an odds ratio of 1.25 (95% confidence interval: 0.77-2.02, <i>P</i> = 0.350), while tertile 3 (9.80-21.88 ng/L) had an odds ratio of 2.07 (95% confidence interval: 1.13-3.80, <i>P</i> = 0.022), with a significant trend (<i>P</i> for trend = 0.022). Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population (<i>P</i> = 0.061 for nonlinearity) and in male (<i>P</i> = 0.136 for nonlinearity) and female (<i>P</i> = 0.067 for nonlinearity) subgroups. Further stratification and sensitivity analyses yielded consistent conclusions.</p><p><strong>Conclusion: </strong>Our study findings suggest that in individuals with type 2 diabetes, detectable hs-TnT levels below the 99^th percentile are associated with DKD.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"99108"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651560","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":"Effects of glycemic indicators on early neurological outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis.","authors":"Zuo-Wei Duan, Zhi-Ning Li, Yu-Jia Zhai, Teng-Fei Liu, Cui-Cui Zhang, Ting Hu, Xiu-E Wei, Liang-Qun Rong, Hai-Yan Liu","doi":"10.4239/wjd.v16.i3.94491","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.94491","url":null,"abstract":"<p><strong>Background: </strong>Stress hyperglycemia (SH) is a common phenomenon that is present in about 50% of patients with acute ischemic stroke (AIS). It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis (IVT).</p><p><strong>Aim: </strong>To investigate the predictive value of glycemic indicators for early neurological outcomes (ENOs) in patients with AIS treated with IVT.</p><p><strong>Methods: </strong>We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, between January 2017 and June 2022. ENO included early neurological improvement (ENI) and early neurological deterioration (END), defined as a decrease or increase in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 24 hours after IVT. We analyzed the associations between glycemic indicators [including admission hyperglycemia (AH), fasting blood glucose (FBG), and SH ratio (SHR)] and ENO in all patients and in subgroups stratified by diabetes mellitus (DM).</p><p><strong>Results: </strong>A total of 819 patients with AIS treated with IVT were included. Among these, AH was observed in 329 patients (40.2%). Compared with patients without AH, those with AH were more likely to have a higher prevalence of DM (<i>P</i> < 0.001) and hypertension (<i>P</i> = 0.031) and presented with higher admission NIHSS scores (<i>P</i> < 0.001). During the first 24 hours after IVT, END occurred in 208 patients (25.4%) and ENI occurred in 156 patients (19.0%). Multivariate mixed logistic regression analyses indicated that END was independently associated with AH [odds ratio (OR): 1.744, 95% confidence interval (CI): 1.236-2.463; <i>P</i> = 0.002]. Subjects were classified into four groups representing quartiles. Compared with Q1, patients in the higher quartiles of SHR (Q2: OR: 2.306, 95%CI: 1.342-3.960; <i>P</i> = 0.002) (Q3: OR: 2.284, 95%CI: 1.346-3.876; <i>P</i> = 0.002) (Q4: OR: 3.486, 95%CI: 2.088-5.820; <i>P</i> = 0.001) and FBG (Q3: OR: 1.746, 95%CI: 1.045-2.917; <i>P</i> = 0.033) (Q4: OR: 2.436, 95%CI: 1.476-4.022; <i>P</i> = 0.001) had a significantly higher risk of END in the overall population. However, none of the glycemic indicators were found to be associated with ENI in patients with or without DM.</p><p><strong>Conclusion: </strong>Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"94491"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651390","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":"Continuum of glucose and bone metabolism impairment across autonomous cortisol secretion: A cross-sectional study.","authors":"Min-Min Han, Xiao-Ming Cao, Zi-Ang Liu, Yi Zhang, Yun-Feng Liu","doi":"10.4239/wjd.v16.i3.100580","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.100580","url":null,"abstract":"<p><strong>Background: </strong>Autonomous cortisol secretion (ACS) is linked to a higher prevalence of metabolic abnormalities and an increased risk of major adverse cardiovascular events.</p><p><strong>Aim: </strong>To evaluate glucose and bone metabolism in patients with ACS using a continuous glucose monitoring system (CGMS) and dual-energy X-ray absorptiometry (DXA).</p><p><strong>Methods: </strong>Patients diagnosed with ACS, including Cushing syndrome, mild ACS (MACS), and nonfunctional adrenal incidentaloma (NFAI), were recruited for this study. Glucose variability and glycemic status were assessed using CGMS. Regional bone mineral content (BMC), bone mineral density (BMD), and bone area (BA) were evaluated using DXA. CGMS- and DXA-derived parameters were compared across the subgroups of ACS. Correlation analysis was performed to examine relationships between varying degrees of cortisol secretion, measured by cortisol after 1 mg overnight dexamethasone suppression test (DST) or 24-hour urine free cortisol (24h UFC), and CGMS- or DXA-derived parameters.</p><p><strong>Results: </strong>A total of 64 patients with ACS were included in this study: 19 with Cushing syndrome, 11 with MACS, and 34 with NFAI. Glucose variability, time above range (TAR), and time in range (TIR) along with specific areal BMC, BMD, and BA, differed significantly between groups of Cushing syndrome and NFAI. A significant positive correlation was observed between glucose variability or TAR and cortisol after 1 mg overnight DST or 24h UFC. By contrast, TIR, along with regional BMC, BMD, and BA, were negatively correlated with varying degrees of cortisol secretion.</p><p><strong>Conclusion: </strong>Glucose and bone metabolism impairments are on a continuum alteration from NFAI to MACS and Cushing syndrome. Prompt attention should be given to these patients with ACS, especially those with mild hormone secretion. Parameters of glucose variability and glycemic status along with bone condition in regions rich in cancellous bone will provide valuable information.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"100580"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650345","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":"Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients.","authors":"Mao-Jun Liu, Jun-Yu Pei, Cheng Zeng, Ying Xing, Yi-Feng Zhang, Pei-Qi Tang, Si-Min Deng, Xin-Qun Hu","doi":"10.4239/wjd.v16.i3.101488","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.101488","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have indicated that triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC) are effective indicators for evaluating insulin resistance. However, research on the association in TyG-WHtR, TyG-WC, and the risk and prognosis of major adverse cardiovascular events (MACEs) in type 2 diabetes mellitus (T2DM) cases are limited.</p><p><strong>Aim: </strong>To clarify the relation in TyG-WHtR, TyG-WC, and the risk of MACEs and overall mortality in T2DM patients.</p><p><strong>Methods: </strong>Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes (ACCORD)/ACCORD Follow-On (ACCORDION) study database. The Cox regression model was applied to assess the relation among TyG-WHtR, TyG-WC and future MACEs risk and overall mortality in T2DM cases. The RCS analysis was utilized to explore the nonlinear correlation. Subgroup and interaction analyses were conducted to prove the robustness. The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.</p><p><strong>Results: </strong>After full adjustment for confounding variables, the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality, than the lowest quartile group. Similarly, the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality, respectively. Each 1 SD increase in TyG-WHtR was significantly related to an 11.7% increase in MACEs and a 14.9% enhance in overall mortality. Each 1 SD increase in TyG-WC corresponded to an 11.5% in MACEs and a 16.6% increase in overall mortality. Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.</p><p><strong>Conclusion: </strong>TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"101488"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651468","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":"Prospects and perils of ChatGPT in diabetes.","authors":"Gumpeny R Sridhar, Lakshmi Gumpeny","doi":"10.4239/wjd.v16.i3.98408","DOIUrl":"https://doi.org/10.4239/wjd.v16.i3.98408","url":null,"abstract":"<p><p>ChatGPT, a popular large language model developed by OpenAI, has the potential to transform the management of diabetes mellitus. It is a conversational artificial intelligence model trained on extensive datasets, although not specifically health-related. The development and core components of ChatGPT include neural networks and machine learning. Since the current model is not yet developed on diabetes-related datasets, it has limitations such as the risk of inaccuracies and the need for human supervision. Nevertheless, it has the potential to aid in patient engagement, medical education, and clinical decision support. In diabetes management, it can contribute to patient education, personalized dietary guidelines, and providing emotional support. Specifically, it is being tested in clinical scenarios such as assessment of obesity, screening for diabetic retinopathy, and provision of guidelines for the management of diabetic ketoacidosis. Ethical and legal considerations are essential before ChatGPT can be integrated into healthcare. Potential concerns relate to data privacy, accuracy of responses, and maintenance of the patient-doctor relationship. Ultimately, while ChatGPT and large language models hold immense potential to revolutionize diabetes care, one needs to weigh their limitations, ethical implications, and the need for human supervision. The integration promises a future of proactive, personalized, and patient-centric care in diabetes management.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 3","pages":"98408"},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651506","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}