Acta Diabetologica最新文献

{"title":"Comparing medication persistence with oral and subcutaneous semaglutide in a real-world setting.","authors":"Matteo Conti, Lorenzo Pontiggia, Michela Vergani, Emanuele Muraca, Rosa Cannistraci, Silvia Perra, Guido Lattuada, Gianluca Perseghin, Stefano Ciardullo","doi":"10.1007/s00592-024-02424-9","DOIUrl":"10.1007/s00592-024-02424-9","url":null,"abstract":"<p><strong>Aims: </strong>To compare medication persistence and efficacy of oral and subcutaneous semaglutide, in a real-world setting.</p><p><strong>Materials and methods: </strong>This is a single-center, retrospective observational cohort study. Patients with type 2 diabetes mellitus (T2DM) starting treatment with either formulation of semaglutide between January 1 2019 and July 31 2023 and with at least one follow-up visit were included. The primary endpoint was the difference in the proportion of patients that continued treatment after 6, 12 and 18 months. Main secondary endpoints were change in HbA1c and body weight.</p><p><strong>Results: </strong>We included 242 patients on oral (n = 121) and subcutaneous (n = 121) semaglutide. At baseline, patients in the oral semaglutide group were significantly older (mean age: 67 ± 11 vs. 63 ± 11 years, p = 0.002) and had a lower body mass index (BMI: 30.5 ± 5.6 vs. 33.9 ± 7.1 kg/m², p < 0.001). The proportion of patients persistent to treatment was significantly lower in the oral group at 6 (85.3% vs. 94.8%; p < 0.001), 12 (72.3% vs. 92.4%, p < 0.001) and 18 (46.0% vs. 83.8%; p < 0.001) months. Most common reasons for discontinuation were gastro-intestinal side effects. When adjusted for age and BMI, body weight and HbA1c reduction were not significantly different between the two formulations, as the proportion of patients achieving the composite outcome of weight loss ≥ 5% and HbA1c < 7.0%.</p><p><strong>Conclusions: </strong>The present real-world study suggests that persistence is significantly lower when semaglutide is administered as a once-daily tablet compared with a weekly injection, while there are no differences in efficacy between the two formulations.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1065-1072"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827146","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 of remnant cholesterol with progression and regression of prediabetes in middle-aged and older adults: a nationwide cohort study.","authors":"Jinyan Jiang, Meichen Chen, Ran Li, Jifang Zhu, Fang Qin, Qian Peng","doi":"10.1007/s00592-024-02416-9","DOIUrl":"10.1007/s00592-024-02416-9","url":null,"abstract":"<p><strong>Background: </strong>The relationship between remnant cholesterol (RC) and outcome of patients with prediabetes remains unclear. This study aims to explore the association between dynamic changes in RC and progression to diabetes or regression to normal blood glucose in pre-diabetic population through a nationwide cohort study.</p><p><strong>Methods: </strong>Based on the China Health and Retirement Longitudinal Study (CHARLS), 2304 participants aged 45 years or older (58.60 ± 8.04 years) who participated in two surveys in 2011 and 2015 were included. Participants were divided into 3 groups according to the tertiles of dynamic changes in RC levels between the two surveys (Q1: ≤ - 1.59, Q2: - 1.59-12.73, Q3: ≥ 12.73, mmol/L). Multivariate Logistic regression models were used to analyze the association of the dynamic changes in RC and the progression and regression of prediabetes. Restricted cubic splines were used to analyze the dose-response relationship between RC and dynamic changes in RC and progression in the prediabetic population.</p><p><strong>Results: </strong>During follow-up, 522 (22.30%) participants developed diabetes, 1283 (54.8%) participants remained prediabetic, and 536 (22.9%) participants regressed to normoglycemia. Further analysis of dynamic changes in RC revealed that reducing RC levels during follow-up reduced the risk of developing diabetes (OR = 0.76, 95% CI: 0.58-0.99, P = 0.04). However, compared with people with increased RC levels, people with prediabetes and stable RC levels are more likely to return to normal blood glucose (OR = 1.45,95% CI: 1.12-1.88, P = 0.005). In the pre-diabetic population, there was non-linear dose-response relationship between the level of RC and dynamic change in RC and the risk of developing diabetes (P nonlinearity < 0.001).</p><p><strong>Conclusion: </strong>Our findings revealed a substantial and non-linear association between dynamic change in RC levels and the outcome of prediabetes. Decreased RC level were associated with reduced risk of progression to diabetes in prediabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1023-1030"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674779","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":"Adipose mesenchymal stem cell-derived extracellular vesicles regulate PINK1/parkin-mediated mitophagy to repair high glucose-induced dermal fibroblast senescence and promote wound healing in rats with diabetic foot ulcer.","authors":"Yinji Luo, Qijie Guo, Chang Liu, Yuxuan Zheng, Yichong Wang, Bin Wang","doi":"10.1007/s00592-024-02422-x","DOIUrl":"10.1007/s00592-024-02422-x","url":null,"abstract":"<p><strong>Aims: </strong>Diabetic foot ulcers (DFUs) cause prominent morbidity and mortality. Adipose mesenchymal stem cell (ASC)-derived extracellular vesicles (EVs) show property in facilitating diabetic wound healing, and we explored their role in DFU rats.</p><p><strong>Methods: </strong>ASCs were cultured in vitro, passaged and then identified by flow cytometry and induction of osteogenic/adipogenic differentiation. ASC-EVs were extracted and identified. DFU rat model was treated with ASC-EVs. High glucose (HG)-induced rat dermal fibroblasts were treated with ASC-EVs or 3-MA and sh-PINK1 plasmid in vitro. Wound healing was observed. Histological changes, inflammatory cytokines (TNF-α, IL-1β), and α-SMA and p21 double-positive cell level were assessed by HE staining, ELISA, and immunofluorescence. Mitochondrial membrane potential (MMP), cell viability and senescence, and ROS production in cells were assessed by fluorescence dye JC-1, CCK-8, SA-β-gal staining, and ROS kit. p21, LC3II/I, p62, PINK1 and parkin protein levels were determined by Western blot.</p><p><strong>Results: </strong>DFU rats had slow wound healing and elevated levels of IL-1β, TNF-α, α-SMA and p21 double-positive cells, and SA-β-gal, while HG-induced cells had weakened viability, elevated ROS, SA-β-gal, p21 and p62 protein levels, and decreased LC3II/I, PINK1 and parkin protein levels and MMP, which were reversed by ASC-EVs. HG inhibited mitophagy by suppressing the PINK1/parkin pathway to accelerate dermal fibroblast senescence. The PINK1/parkin pathway inhibition partly mitigated the effect of ASC-EVs. ASC-EVs promoted mitophagy by activating the PINK1/parkin pathway in vivo.</p><p><strong>Conclusions: </strong>ASC-EVs mediated mitophagy by activating the PINK1/parkin pathway, thereby impeding HG-induced rat dermal fibroblast senescence and promoting wound healing in DFU rats.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1041-1056"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827143","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":"Short-term results of EUS-guided RFA of insulinoma: a case series.","authors":"Nevena Chakarova, Petko Karagyozov, Inna Yankova, Roumyana Dimova, Tsvetalina Tankova","doi":"10.1007/s00592-025-02460-z","DOIUrl":"10.1007/s00592-025-02460-z","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1161-1165"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582155","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":"Unmasking heterogeneity in type 2 diabetes: the clinical relevance of phenotyping in the era of precision medicine.","authors":"Salvatore Corrao, Massimo Federici","doi":"10.1007/s00592-025-02556-6","DOIUrl":"https://doi.org/10.1007/s00592-025-02556-6","url":null,"abstract":"<p><p>Despite its widespread use in clinical practice, the traditional dichotomous classification of diabetes into type 1 and type 2 fails to capture the marked heterogeneity observed in real-world patients, particularly those with type 2 diabetes mellitus (T2DM). The increasing recognition of the complex interplay between insulin resistance, beta-cell dysfunction, autoimmunity, and genetic predisposition has led to the development of phenotypic classification systems that aim to individualize care beyond glycemic targets. Ahlqvist et al. made a major contribution to this field by identifying five clinically meaningful clusters of adult-onset diabetes using routine clinical variables. These clusters differ in their metabolic profiles, complication risks, and therapeutic needs, offering a pragmatic starting point for personalized diabetology. Their clinical relevance has been further explored and validated by follow-up studies that include detailed metabolic phenotyping, cardiac imaging, and genetic analyses. Nevertheless, enthusiasm for cluster-based models must be tempered by critical appraisal. Evidence from large trials suggests that continuous clinical features may better predict disease progression and treatment response than static cluster assignments. Furthermore, these models have yet to be integrated into clinical guidelines or electronic decision-support systems. This Perspective argues for a multidimensional and dynamic approach to diabetes phenotyping, combining clinical, biochemical, imaging, and genetic data to reflect the evolving nature of the disease. Such a framework could enable more precise stratification and intervention, moving toward truly personalized diabetes care. Integrating these models into real-world settings represents the next frontier in precision diabetology.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537711","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 estimated glucose disposal rate and kidney function decline in different glucose tolerance statuses from the 4 C study.","authors":"Peiqiong Luo, Danpei Li, Yaming Guo, Xiaoyu Meng, Ranran Kan, Xuefeng Yu","doi":"10.1007/s00592-024-02432-9","DOIUrl":"10.1007/s00592-024-02432-9","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the association between estimated glucose disposal rate (eGDR) and kidney function decline among populations with different glucose tolerance statuses including normal glucose tolerance (NGT), prediabetes, and diabetes.</p><p><strong>Methods: </strong>The present study analyzed 5,069 participants from a cohort study. The association between eGDR and kidney function decline was assessed using binary logistic regression. Restricted cubic splines (RCS) analyses were also performed to investigate the dose-dependent associations.</p><p><strong>Results: </strong>During up to 5 years of follow-up, 116 (2.30%) individuals experienced kidney function decline. Binary logistic regression showed that an increased level of eGDR was associated with decreased risk of kidney function decline after full adjustment, in all participants (Q4 vs. Q1 HR 0.13, 95% CI 0.05-0.30, p = 0.001), prediabetes (Q4 vs. Q1HR 0.11, 95% CI 0.01-0.44, p = 0.007), and diabetes (Q4 vs. Q1 HR 0.06, 95% CI 0.00-0.37, p = 0.012), but not in those with NGT. RCS analyses suggested dose-dependent relationships of eGDR with the risk of kidney function decline in all participants (L-shaped curve) and those with prediabetes (inverted U-shaped curve) and diabetes (L-shaped curve).</p><p><strong>Conclusions: </strong>The association between elevated baseline eGDR and reduced risk of kidney function decline was significant in participants with prediabetes and diabetes, but not in those with NGT. These dose-dependent associations may have important implications for the assessment of high-risk patients by healthcare professionals and may lead to the development of more tailored and effective prevention strategies.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1129-1138"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845487","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":"Factors associated with intensive care unit admission due to diabetic ketoacidosis in adults: a validated predictive model.","authors":"Fernando Sebastian-Valles, Andrés Carlos Von Wernitz Teleki, Maria Sara Tapia-Sanchiz, Victor Navas-Moreno, Marta Lopez-Ruano, Carmen Martinez-Otero, Elena Carrillo-López, Carolina Sager-La Ganga, Juan José Raposo-López, Selma Amar, Sara González Castañar, Jose Alfonso Arranz-Martin, Carmen Del Arco, Mónica Marazuela","doi":"10.1007/s00592-024-02421-y","DOIUrl":"10.1007/s00592-024-02421-y","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to develop a predictive model capable of determining the need for intensive care unit (ICU) admission of patients with diabetic ketoacidosis (DKA) during their assessment in the Emergency Department.</p><p><strong>Methods: </strong>This is an observational study of consecutive cases including all adult patients diagnosed with DKA at a tertiary hospital between 2010 and 2024. Variables from medical history, physical examination, and laboratory tests at admission were collected and studied for their association with ICU admission. The sample was divided into two randomized parts: one to build a logistic regression model and another to validate it.</p><p><strong>Results: </strong>Two hundred and thirty-one DKA events were included. Individuals had a mean age of 49.6 ± 19.9 years and 50.2% were male. Forty-eight point five percent of cases required ICU admission, and 30-day mortality was 4.8%. The best model to predict ICU admission included Glasgow Coma Scale (odds ratio [OR] = 0.64, p = 0.003), pH (OR = 0.0088, p = 0.005), bilirubin (OR = 0.13, p = 0.036), bicarbonate (OR = 0.0091, p = 0.013), and pH-bicarbonate interaction (OR = 3.78, p = 0.015). The model had an R² of 0.561, and the area under the curve (AUC) in the validation cohort was 0.842. Internal validation by bootstrap resampling showed an AUC = 0.871.</p><p><strong>Conclusion: </strong>Variables associated with the severity of acidosis in patients with DKA predict the need for ICU admission better and earlier than other clinical variables.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1031-1039"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827148","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":"The association between plasma lipidome and diabetic microangiopathy: a mendelian randomization study.","authors":"Yi Wei, Jiangyi Yu","doi":"10.1007/s00592-024-02414-x","DOIUrl":"10.1007/s00592-024-02414-x","url":null,"abstract":"<p><strong>Background: </strong>Current studies have identified severe lipid metabolism diseases in diabetic microangiopathy patients, especially in diabetic kidney disease (DKD), diabetic retinopathy (DR) and diabetic neuropathy (DN), with unclear causal relationships.</p><p><strong>Methods: </strong>We employed a large-scale dataset containing 179 lipid species as the exposure and large-scale public summary-level datasets of DKD, DR and DN as the outcome. We applied Mendelian randomization (MR) approach to explore causal associations between circulating liposomes and diabetic microangiopathy. A sequence of sensitivity tests was conducted to verify the stability of the MR analysis.</p><p><strong>Results: </strong>We manifest that diacylglycerol (18:1_18:3) (OR = 0.716, 95%CI = 0.559-0.917, P = 0.008), triacylglycerol (OR:0.741-0.763, P < 0.05) and phosphatidylcholine (OR:0.620-1.247, P < 0.05) have a potential association with DKD. And there is a nominal causal effect of phosphatidylinositol (16:0_18:2) (OR = 0.617, 95%CI = 0.401-0.948, P = 0.028), phosphatidylcholine (OR:0.499-0.672, P < 0.05) and sphingomyelin (OR:0.652-1.850, P < 0.05) to DR. In addition, phosphatidylethanolamine (18:1_0:0) (OR = 0.616, 95%CI = 0.405-0.935, P = 0.023), diacylglycerol (16:0_18:1) (OR = 0.675, 95%CI = 0.463-0.984, P = 0.041) and phosphatidylcholine (OR = 0.720-1.619, P < 0.05) nominally associate with DN. It is noteworthy that plasma lipidome of different structures show different effects.</p><p><strong>Conclusion: </strong>We establish a possible causal connection between certain plasma lipidome and major diabetic microangiopathies. Implementing intervention strategies targeting different lipid molecules may provide novel approaches for preventing and treating diabetic microangiopathies.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1001-1008"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638311","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":"Fracture events associated with GLP-1 receptor agonists in FDA adverse events reporting system.","authors":"Yao Xiao, Min Zhou, Wenfeng Xiao","doi":"10.1007/s00592-024-02415-w","DOIUrl":"10.1007/s00592-024-02415-w","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes patients are at a higher risk of fractures, and glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been suggested to positively impact on bone metabolism. We aim to provide a comprehensive assessment of fracture events associated with GLP-1RAs based on pharmacovigilance data.</p><p><strong>Methods: </strong>In this study, fracture-related adverse events (AEs) associated with GLP-1RAs and other commonly used glucose-lowering drugs were identified from Food and Drug Administration Adverse Event Reporting System (FAERS) database (2004-2022). The reporting odds ratio (ROR) and adjusted ROR (adj. ROR) were used to compare the reporting of fracture-related AEs associated with insulin, GLP-1RAs, and Non GLP-1RAs, in patients with diabetes through two scenarios. This involved separately comparing each glucose-lowering drug to all other medications used in diabetic patients and reiterating after excluding insulin cases.</p><p><strong>Results: </strong>A total of 490,107 AE reports for patients with diabetes were identified and 98, 625 of them were for GLP-1RAs. Among all diabetes drugs, GLP-1RAs had the lowest reporting of any fracture-related AEs [adj. ROR = 0.44 (0.40-0.47)], consistent across osteoporotic fracture [adj. ROR = 0.39 (0.34-0.45)] and hip fracture [adj. ROR = 0.34 (0.28-0.41)]. Among GLP-1RA agents, albiglutide was associated with the lowest adj. ROR [0.11 (0.05-0.21)] for any fracture-related AEs. After excluded all insulin reports, GLP-1RAs retained a significantly lower adj. ROR towards any fracture [adj. ROR = 0.45 (0.40-0.50)], osteoporotic fracture [adj. ROR = 0.44 (0.37-0.52)], and hip fracture [adj. ROR = 0.43 (0.33-0.54)].</p><p><strong>Conclusion: </strong>In a real-world pharmacovigilance setting, GLP-1RAs were associated with lower reporting of fracture-related AEs, indicating the protective effect of GLP-1RAs against fractures.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"1009-1021"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646742","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":"The role of fecal microbiota transplantation in diabetes.","authors":"Gabriele Angelo Vassallo, Tommaso Dionisi, Vittorio De Vita, Giuseppe Augello, Antonio Gasbarrini, Dario Pitocco, Giovanni Addolorato","doi":"10.1007/s00592-025-02508-0","DOIUrl":"10.1007/s00592-025-02508-0","url":null,"abstract":"<p><p>Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic strategy for modulating gut dysbiosis in diabetes mellitus. This review critically evaluates preclinical and clinical evidence on FMT in type 1 (T1D) and type 2 diabetes (T2D). Studies suggest that FMT can restore microbial diversity, improve glycemic control, and modulate immune responses, with varying effects across diabetes subtypes. In T1D, preclinical models demonstrate that FMT influences regulatory T-cell expansion and β-cell preservation, though clinical translation remains limited. In T2D, FMT has shown transient improvements in insulin sensitivity, with sustained effects observed only in patients with specific microbiome signatures. However, heterogeneity in patient responses, donor variability, and methodological limitations complicate its clinical application. This review highlights the interplay between FMT, immune modulation, and microbial metabolism, advocating for phenotype-stratified trials and multi-omics integration to enhance therapeutic precision.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":"977-981"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951894","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}