Acta Diabetologica最新文献

{"title":"The effect of GLP-1 receptor agonists on osteoarthritis risk in individuals with type 2 diabetes mellitus: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Limin Zhou, Peiyang Wu, Yongxiang Xu, Baocheng Xie","doi":"10.1007/s00592-026-02697-2","DOIUrl":"https://doi.org/10.1007/s00592-026-02697-2","url":null,"abstract":"<p><strong>Objective: </strong>Current research has not yet drawn a definitive conclusion on the impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on the risk of osteoarthritis (OA) in patients with type 2 diabetes mellitus (T2DM). To supplement the evidence base in this field, the present study sought to systematically investigate the association between GLP-1RA administration and the risk of OA in adult T2DM patients through a meta-analysis of relevant randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>An exhaustive literature search was conducted across five major databases-PubMed, Embase, Web of Science, ClinicalTrials.gov, and the Cochrane Library-covering the period from each database's inception up to May 6, 2025. The main objective of this literature search was to identify RCTs that enrolled adult patients with T2DM receiving GLP-1RAs and reported OA incidence. The Cochrane Risk of Bias 2.0 tool was employed to evaluate the risk of bias for all included studies, while the GRADE system was applied to assess the overall certainty of the evidence. Additionally, the node-splitting method was utilized to perform inconsistency testing between direct and indirect evidence. The occurrence of OA events was defined as the primary outcome of the study. A series of analyses were performed to evaluate the impact of each intervention on OA risk, including traditional meta-analysis, frequentist network meta-analysis (NMA), and sensitivity analysis. Summary estimates of effect size were presented as relative risk (RR) along with 95% confidence intervals (CI).</p><p><strong>Results: </strong>The present study ultimately included 74 RCTs with a combined sample size of 105,415 individuals. Conventional pairwise meta-analysis revealed no statistically significant difference in OA risk between GLP-1RAs and placebo, insulin, or other oral antidiabetic drugs (OADs). Stratified subgroup analyses based on GLP-1RA formulation, treatment duration, and control group type also found no statistically significant differences in OA risk across all subgroups. Furthermore, NMA results indicated no notable variations in OA risk between GLP-1RAs and control interventions, and no such differences were observed among the different GLP-1RA formulations either. Sensitivity analyses verified the stability and reliability of the study outcomes.</p><p><strong>Conclusions: </strong>Among adult patients with T2DM, there was no significant difference in OA risk between GLP-1RA treatment and placebo, insulin, or OADs; this absence of statistical significance was also observed across different GLP-1RA formulations, varying treatment durations, and distinct control groups.</p><p><strong>Prospero registration number: </strong>CRD420251034203.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of controlled type 2 diabetes on muscle-tendon mechanics.","authors":"Riccardo Magris, Andrea Monte, Nicolò Vigolo, Francesca Nardello, Michele Trinchi, Carlo Negri, Paolo Gisondi, Chiara Cosma, Giovanni Sartore, Annunziata Lapolla, Paolo Moghetti, Paola Zamparo","doi":"10.1007/s00592-026-02705-5","DOIUrl":"https://doi.org/10.1007/s00592-026-02705-5","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate the impact of type 2 diabetes (T2D) on muscle and tendon mechanics by comparing individuals with controlled diabetes to a healthy cohort matched for age, BMI, and physical activity level. A secondary aim was to investigate the possible association between muscle-tendon proprieties and glycated haemoglobin (HbA1c) or advanced glycated end products (AGE, RAGE) as determined in blood and skin biopsies.</p><p><strong>Methods: </strong>Twenty-eight patients and eighteen controls were recruited for this study. Achilles tendon stiffness (k_T), muscle-tendon stiffness (k_M, in gastrocnemius medialis) and the rate of torque development (RTD) were evaluated by combining dynamometric and ultrasound data.</p><p><strong>Results: </strong>Diabetic patients showed increased tendon stiffness and reduced tendon elongation compared to controls, but similar RTD and k_M values. No differences in advanced glycation end products (in serum or biopsies) were observed between cohorts, but a significant positive correlation was observed between k_T and HbA1c (r = 0.610, N = 46, P < 0.001).</p><p><strong>Conclusion: </strong>Our data indicate that muscle, but not tendon, properties can be preserved in controlled and physically active diabetic patients and that higher tendon stiffness does not result in a functional deficit (i.e., same explosive capacity between cohorts). Although this study is cross-sectional and has a limited sample size, our data suggest a potential role of HbA1c as a non-invasive biomarker of altered tendon mechanics in people with diabetes.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov, protocol number: </strong>NCT05585502.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro and in silico analysis of three variants associated with type 2 diabetes.","authors":"Seyyed Amin Seyyed Rezaei, Moein Kohkalani, Maghsoud Mehri, Sima Mansoori Derakhshan, Fernando Berton Zanchi, Rafael Andrade Caceres, Akbar Amirfiroozi","doi":"10.1007/s00592-026-02689-2","DOIUrl":"https://doi.org/10.1007/s00592-026-02689-2","url":null,"abstract":"<p><strong>Background: </strong>Common regulatory and coding variants may influence type 2 diabetes (T2D) risk by altering gene regulation or protein function. Identifying these variants and their associations with disease risk may inform disease control strategies. This study prioritized candidate variants by integrating two-group comparative genotyping with in-silico structural and dynamic analyses.</p><p><strong>Methods: </strong>Three prioritized variants (two missense, one TF-binding-site) were genotyped in 101 T2D cases and 100 controls from the Azeri population of Iran. Variant calls were validated by Sanger sequencing. Structural modelling, ligand docking, and 100-nanosecond molecular dynamics simulations were performed to assess molecular consequences.</p><p><strong>Results: </strong>The TF-binding-site variant in PPP2R3A (rs184442184) was significantly associated with T2D (allelic OR ≈ 1.71, p = 0.014; TT OR ≈ 2.92, p = 0.020) and is located at a RegulomeDB 2a site overlapping EGR1/SP motifs. SLC39A11 (ZIP11) rs61736066 (A allele) was enriched in cases (allelic OR ≈ 1.87, p = 0.002; AA OR ≈ 3.49, p = 0.005), and the variant model demonstrated increased RMSD/RMSF, helix displacement, and modest destabilization. The TPCN2 missense variant exhibited only subtle in-silico effects and no genetic association.</p><p><strong>Conclusion: </strong>These findings highlight PPP2R3A rs184442184 and SLC39A11 rs61736066 as promising T2D candidate variants, supported by concordant genetic signals and mechanistic in-silico effects. The TPCN2 substitution demonstrated only mild structural changes and no association in this study. Overall, these results provide testable biological hypotheses that require validation through larger replication studies and targeted functional assays.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthostatic hypotension as a marker of increased arterial stiffness in diabetes mellitus.","authors":"Merve Oruc, Ozant Helvacı, Ahmet Oruc, Ulver Derici","doi":"10.1007/s00592-026-02704-6","DOIUrl":"https://doi.org/10.1007/s00592-026-02704-6","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic hypotension (OH) is associated with adverse cardiovascular outcomes and may reflect underlying autonomic and vascular dysfunction. Arterial stiffness is a key determinant of cardiovascular risk; however, its relationship with OH in patients with diabetes mellitus (DM) remains unclear.</p><p><strong>Objective: </strong>To evaluate factors associated with OH and investigate the relationship between arterial stiffness parameters and OH in patients with DM.</p><p><strong>Methods: </strong>This single-center cross-sectional study included 193 patients with DM. Orthostatic blood pressure was measured in the supine position and 3 min after standing. Arterial stiffness was assessed using oscillometric pulse wave velocity (PWV) and related parameters with the Mobil-O-Graph device. Clinical, laboratory, and medication data were analyzed. Logistic regression analyses were performed to identify factors associated with OH.</p><p><strong>Results: </strong>OH was present in 56 patients (29%). Patients with OH had significantly higher central blood pressure and arterial stiffness parameters, including PWV, augmentation pressure, and augmentation index. In multivariate analysis, female sex, older age, diabetic neuropathy, and PWV were independently associated with OH. PWV remained significantly associated with OH after adjustment for confounders. No significant differences were observed between groups regarding antihypertensive medication classes.</p><p><strong>Conclusion: </strong>In patients with DM, OH is independently associated with increased arterial stiffness and diabetic neuropathy. These findings suggest a link between orthostatic blood pressure dysregulation and adverse vascular characteristics. Prospective studies are needed to clarify causal relationships and clinical implications.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"The combination of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors: a narrative review of existing meta-analysis\".","authors":"Bin Cao, Ming Ouyang","doi":"10.1007/s00592-026-02700-w","DOIUrl":"https://doi.org/10.1007/s00592-026-02700-w","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperglycemia-driven metabolic memory signaling destabilizes METTL1 to trigger inflammatory hypertrophy and fibrosis in diabetic cardiomyopathy.","authors":"Yurui Yuan, Ang Zhang, Ying Jiang, Dayun Tao, Zhijiang Guo, Hang Zhu, Yu Zeng, Hongshuo Shi","doi":"10.1007/s00592-026-02699-0","DOIUrl":"https://doi.org/10.1007/s00592-026-02699-0","url":null,"abstract":"<p><strong>Background: </strong>Diabetic cardiomyopathy (DCM) occurs in the context of coronary artery disease or pressure overload heart disease, characterized by alterations in cardiac structure and function. The mechanisms linking metabolic memory and METTL1-mediated modifications to DCM progression remain unclear.</p><p><strong>Methods: </strong>This study integrated multiple public transcriptome datasets to conduct a systematic analysis of gene expression profiles associated with diabetic cardiomyopathy. Potential key characteristic genes were identified through differential expression analysis and machine learning techniques. Their associated biological processes and signaling pathways were assessed using functional enrichment analysis. Additionally, single-cell RNA sequencing data were employed to examine the expression and distribution of key genes across various cardiac cell types, while gene set enrichment analysis (GSEA) was utilized to explore their potential functional networks.</p><p><strong>Results: </strong>The integration of three public transcriptome datasets and subsequent differential expression analysis identified 159 genes associated with diabetic cardiomyopathy, of which 133 were upregulated and 26 downregulated. These differentially expressed genes (DEGs) effectively distinguished between DCM and control samples. Machine learning analyses, including LASSO regression and random forest, identified several key candidate genes, with METTL1 showing a significant association with inflammation, fibrosis, and metabolic disorders. In multiple independent datasets, METTL1 expression was markedly elevated in DCM samples and demonstrated substantial diagnostic potential (ROC AUC = 0.826). Functional enrichment analysis revealed that METTL1-related genes predominantly participated in pathways related to white blood cell migration, inflammatory activation, and extracellular matrix remodeling. Single-cell RNA sequencing further indicated that METTL1 was primarily enriched in the fibroblast population. The proportion of METTL1-positive fibroblasts in DCM samples was significantly increased and was associated with inflammatory and fibrosis-related signaling pathways. A comprehensive analysis suggests that METTL1 may play a role in the pathological progression of DCM by regulating fibroblast activation, amplifying inflammation, and contributing to myocardial remodeling.</p><p><strong>Conclusions: </strong>This study elucidates the expression characteristics of METTL1 and its potential regulatory functions in diabetic cardiomyopathy. The findings suggest that METTL1 metabolic memory may be influenced by RNA modifications occurring in the context of persistent inflammation and fibrosis.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifications on the report of maternally inherited diabetes and deafness managed with an advanced hybrid closed loop system.","authors":"Michalis K Picolos, Anastasia Papapostolou, Anastasia Christodoulou, George A Tanteles, Anna Kyriakidou, Georgios S Papaetis","doi":"10.1007/s00592-026-02698-1","DOIUrl":"https://doi.org/10.1007/s00592-026-02698-1","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of complication burden in people with diabetes: a latent class analysis approach.","authors":"Bárbara Maria Farias Kruschewsky, Roseanne Montargil Rocha, Marcelo Araújo, Rafael Ernane Andrade, Icaro J S Ribeiro","doi":"10.1007/s00592-026-02703-7","DOIUrl":"https://doi.org/10.1007/s00592-026-02703-7","url":null,"abstract":"<p><strong>Aims: </strong>To identify patterns of complication burden among individuals with diabetes mellitus based on sociodemographic, behavioral, and clinical characteristics, and to examine their co-occurrence with diabetes-related comorbidities.</p><p><strong>Methods: </strong>This cross-sectional study was conducted during a diabetes health campaign in a municipality in southern Bahia, Brazil, involving 1,542 patients. Data were obtained through a standardized questionnaire and ophthalmological examinations. Latent class analysis was applied to identify subgroups with similar clinical characteristics. Models with two to four classes were estimated, with the two-class model presenting the most parsimonious and interpretable solution according to BIC. Associations between classes and comorbidities were estimated using Poisson regression with robust variance, adjusted for age and sex.</p><p><strong>Results: </strong>Two classes were identified. Class 1 (86.6%) showed lower complication burden, with preserved vascular and sensory function. Class 2 (13.4%) was characterized by a higher frequency of ulceration, amputation, absent peripheral pulses, and impaired protective sensation. Individuals in Class 2 presented higher prevalence of cardiovascular disease (PR = 1.47), myocardial infarction (PR = 1.64), neurological disease (PR = 1.67), and retinopathy (PR = 1.63).</p><p><strong>Conclusion: </strong>The identified classes primarily reflect differences in peripheral complication burden, with higher co-occurrence of vascular and microvascular conditions in the more affected group. These findings describe patterns of complication clustering within a screening population and may support population-level strategies for identifying individuals with greater healthcare needs.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-fidelity simulation-based validation of applicability of the new Italian society for pediatric endocrinology and diabetes (ISPED) recommendations for pediatric diabetic ketoacidosis management.","authors":"Ivana Rabbone, Andrea Scaramuzza, Erica Pozzi, Elena Corti, Alice Monzani, Federico Lorenzo Barra, Massimo Canonico, Luisa Fernanda Barrera Leon, Marta Bassi, Riccardo Bonfanti, Francesca Di Candia, Giulio Frontino, Dario Iafusco, Fortunato Lombardo, Maddalena Macedoni, Valentina Mancioppi, Marco Marigliano, Mariangela Martino, Riccardo Schiaffini, Valentina Tiberi, Davide Tinti, Sonia Toni, Valentino Cherubini","doi":"10.1007/s00592-026-02672-x","DOIUrl":"https://doi.org/10.1007/s00592-026-02672-x","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between diabetes and tinnitus traits in the UK Biobank: a population-based cohort study.","authors":"Xiaoqin Ji, Ziyan Zhang, Xiuli Shao, Rong Yu, Deying Gu, Jianjun Ren, Huiling Zhao","doi":"10.1007/s00592-026-02695-4","DOIUrl":"https://doi.org/10.1007/s00592-026-02695-4","url":null,"abstract":"<p><strong>Objectives: </strong>Tinnitus is common but challenging to treat. Investigating diabetes-related factors may inform prevention and targeted interventions. This study evaluated associations between diabetes-related factors and tinnitus traits.</p><p><strong>Methods: </strong>Using UK Biobank data (n = 136,181), we performed cross-sectional logistic regression to evaluate links between diabetes status, HbA1c, medication use, and diabetes duration with tinnitus occurrence, frequency, and severity. Subgroup analyses assessed variations by sex and age.</p><p><strong>Results: </strong>This study systematically identified the associations between diabetes-related factors and the frequency and severity of tinnitus. Patients with type 2 diabetes had higher odds of experiencing current, constant, and upsetting tinnitus (OR: 2., 95% CI: 1.4-2.85, p = 0.001; OR: 2.49, 95% CI: 1.44-4.31, p = 0.0011; OR: 6.36, 95% CI: 2.3-17.54, p = 0.001, respectively). Insulin use was associated with lower odds of developing current, transient, and upsetting tinnitus compared to non-users of hypoglycemic drugs (OR: 0.61, 95% CI: 0.47-0.80; OR: 0.62, 95% CI: 0.43-0.9, p = 0.011; OR: 0.42, 95% CI: 0.25-0.69, p = 0.007, respectively). Subgroup analyses revealed stronger associations in younger females.</p><p><strong>Conclusions: </strong>Type 2 diabetes increases tinnitus risk, whereas insulin use was associated with a lower prevalence of tinnitus. Notably, diabetes status and HbA1c were significantly associated with tinnitus, mainly in younger females.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}