Acta Diabetologica最新文献

{"title":"GSTP1 expression mitigates endothelial dysfunction in diabetic retinopathy through regulation of oxidative stress: insights from single-cell RNA sequencing.","authors":"Rongle Zhou, Mingrong Kou, Shanshuang Du","doi":"10.1007/s00592-026-02775-5","DOIUrl":"https://doi.org/10.1007/s00592-026-02775-5","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic retinopathy (DR) remains a major microvascular complication of diabetes, with substantial global variations in prevalence and severity. This study aimed to investigate alterations in the immune microenvironment of diabetic retinopathy and explore key regulatory mechanisms in endothelial cells.</p><p><strong>Methods: </strong>We analyzed immune microenvironment differences between DR and non-DR samples using single-cell sequencing data. Key modules and genes in endothelial cells were identified through hdWGCNA analysis. The expression of GSTP1 and its effects on apoptosis and reactive oxygen species (ROS) were validated in a DR endothelial cell model.</p><p><strong>Results: </strong>Single-cell analysis revealed significantly decreased T cell populations in DR patients with notable differences in endothelial cell profiles between groups. Further examination of endothelial cells demonstrated upregulation of metabolic pathways and major histocompatibility complex (MHC) functions in DR patients. Notably, GSTP1 was identified as a significantly downregulated gene in DR. In the in vitro DR endothelial cell model, GSTP1 overexpression significantly increased cell viability, while decreasing apoptosis and ROS accumulation.</p><p><strong>Discussion: </strong>This study identifies an altered immune microenvironment in diabetic retinopathy (DR), characterized by T-cell decrease and upregulated endothelial cell pathways. The key finding is that the low expression of GSTP1 impairs endothelial antioxidant capacity, while its overexpression mitigates apoptosis and oxidative stress, underscoring its protective role in DR. These results position GSTP1 as a promising therapeutic target for intervening in DR progression.</p><p><strong>Conclusion: </strong>Our findings provide novel insights into GSTP1's role in DR pathogenesis and offer theoretical support for developing GSTP1-based therapeutic strategies for diabetic retinopathy.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981840","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":"MASLD in type 2 diabetes: steatosis-fibrosis burden and metabolic determinants in a real-world cohort.","authors":"Salvatore Corrao, Salvatore Scibetta, Brenda Bongiorno, Carola Lopriore, Luigi Calvo","doi":"10.1007/s00592-026-02791-5","DOIUrl":"https://doi.org/10.1007/s00592-026-02791-5","url":null,"abstract":"<p><strong>Aims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in type 2 diabetes mellitus (T2DM), but the burden of steatosis and fibrosis and their associated factors remain incompletely defined. We assessed the prevalence, severity, and factors associated with of MASLD in a real-world cohort of patients with T2DM.</p><p><strong>Methods: </strong>In this cross-sectional study, 219 consecutive outpatients with T2DM underwent anthropometric laboratory, ultrasonographic and shear-wave elastographic assessment. MASLD was defined by the multisociety Delphi consensus. Independent associations were evaluated using multivariable logistic regression, with waist circumference as the primary adiposity measure.</p><p><strong>Results: </strong>MASLD was diagnosed in 75.3% of participants. Severe steatosis (S3) was present in 11.9%, clinically significant fibrosis (F ≥ 2) in 7.3%, and advanced fibrosis (F ≥ 3) in 5.5%. Male sex (OR 2.49, 95% CI 1.26-4.94) and waist circumference (OR 1.04 per cm, 95% CI 1.01-1.07) were independently associated with MASLD. Severe steatosis was independently associated with male sex and waist circumference. MASLD prevalence increased across waist circumference quartiles (trend p = 0.001), while the adjusted odds plateaued in the upper half, paralleled by a higher prevalence of severe steatosis (p < 0.001), whereas fibrosis was not associated with abdominal adiposity (p = 0.65). HbA1c and diabetes duration did not differ between groups in univariable comparisons, and age was not associated with MASLD in the multivariable models.</p><p><strong>Conclusions: </strong>MASLD is highly prevalent in T2DM and is independently associated with male sex and central adiposity. Abdominal adiposity identifies steatosis risk in a graded manner but does not discriminate fibrosis, supporting adiposity- and sex-informed hepatic phenotyping in patients with T2DM.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928651","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":"Clinical utility of transient elastography for assessing prevalent coronary heart disease in individuals with type 2 diabetes mellitus.","authors":"Jie-Wen Lei, Jian-Guo Sheng, Wan-Bin Li, Yan-Yan Tao, Jia Guo, Yan Zhang","doi":"10.1007/s00592-026-02787-1","DOIUrl":"10.1007/s00592-026-02787-1","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the use of transient elastography (TE) to assess the severity of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), in patients with type 2 diabetes mellitus (T2DM), with the aim of exploring the cross-sectional association between hepatic steatosis and prevalent coronary heart disease (CHD) in this population.</p><p><strong>Methods: </strong>A total of 104 patients with T2DM were included. TE measurements were obtained using FibroScan^® (Paris, France) to determine liver stiffness values, reflecting the degree of hepatic fibrosis, and the controlled attenuation parameter (CAP), which quantifies hepatic steatosis. The presence of CHD was evaluated by coronary computed tomography angiography (CTA), with invasive coronary angiography reserved for definitive confirmation in cases with CTA findings suggestive of significant stenosis. Statistical analyses comprised univariate and multivariate logistic regression models, along with receiver operating characteristic (ROC) curve analysis. The events-per-variable ratio was approximately 10. Internal validation was performed using 1,000-fold bootstrap resampling.</p><p><strong>Results: </strong>Based on coronary CTA findings, patients were categorized into a CHD group (n = 50) and a non-CHD group (n = 54). Both univariate and multivariate logistic regression analyses identified CAP values (p < 0.001) and glycosylated hemoglobin (HbA1c) levels (p < 0.001) as variables independently associated with prevalent CHD among patients with T2DM. The area under the ROC curve (AUC) for CAP in discriminating CHD status was 0.828, whereas the AUC for HbA1c was 0.695. Combined analysis of CAP and HbA1c yielded an AUC of 0.848. Although the absolute increase in AUC was modest, integrated discrimination improvement (IDI = 0.023, p = 0.038) and category‑free net reclassification improvement (NRI = 0.186, p = 0.041) indicated meaningful reclassification of CHD status, supporting the incremental value of the combined model.</p><p><strong>Conclusions: </strong>CAP, a quantitative indicator reflecting MASLD severity, is strongly associated with prevalent CHD in patients with T2DM. The combined assessment of CAP and HbA1c enhances the accuracy of CHD status discrimination in this population.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910517","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":"Multi-ancestry polygenic risk scores: toward equitable prediction of type 2 diabetes and its complications.","authors":"Reja Ahmad, Safia Bibi, Mazhar Ali, Muhammad Dawar Zahid","doi":"10.1007/s00592-026-02772-8","DOIUrl":"https://doi.org/10.1007/s00592-026-02772-8","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910519","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":"7-Ketocholesterol-induced oxidative stress impairs insulin secretion in pancreatic β-cells.","authors":"Wenjing Zhang, Jiahua Wu, Yuchen Zhao, Nan Wu, Shuiya Sun, Sunyue He, Xihua Lin, Jiaqiang Zhou","doi":"10.1007/s00592-026-02781-7","DOIUrl":"https://doi.org/10.1007/s00592-026-02781-7","url":null,"abstract":"<p><strong>Aims: </strong>Glucolipotoxicity-induced β-cell dysfunction is a key factor in the pathogenesis of type 2 diabetes (T2D). While cholesterol is known to contribute to this dysfunction, the specific role of its major oxidation product, 7-ketocholesterol, remains unclear.</p><p><strong>Methods: </strong>We quantified serum 7-ketocholesterol levels using UPLC-MS in a cohort comprising individuals with T2D and normal glucose tolerance (NGT). Using INS-1 cells and primary islets, we investigated the effects of 7-ketocholesterol on β-cell function (including glucose-stimulated insulin secretion [GSIS], perfusion and calcium dynamics) and the underlying mechanisms related to oxidative stress (reactive oxygen species [ROS], mitochondrial membrane potential [MMP], ATP) and gene/protein expression. The antioxidant N-Acetyl-L-cysteine (NAC) was employed to rescue the observed dysfunction.</p><p><strong>Results: </strong>Cohort analysis showed serum 7-ketocholesterol levels were significantly elevated in T2D patients compared to NGT controls (0.070 ± 0.035 vs. 0.051 ± 0.021 µmol/L), and this elevation correlated negatively with early-phase insulin secretion. In INS-1 cells and primary islets, 7-ketocholesterol exposure impaired GSIS and disrupted intracellular calcium signaling. Furthermore, 7-ketocholesterol induced marked oxidative stress, characterized by increased ROS production, loss of MMP, and reduced ATP levels. Mechanistically, 7-ketocholesterol promoted NRF2 nuclear translocation and upregulated the expression of antioxidant genes, including Gpx4 and Sod1. Critically, co-treatment with NAC attenuated 7-ketocholesterol-induced oxidative stress and restored insulin secretion and calcium signaling.</p><p><strong>Conclusion: </strong>Our findings suggest that elevated 7-ketocholesterol is associated with β-cell dysfunction in T2D patients and appears to impair insulin secretion by inducing oxidative stress in pancreatic β-cells, positioning 7-ketocholesterol as a potential contributor to diabetes progression.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148885846","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":"Load-capacity index and cardiometabolic risk: a longitudinal meta-analysis.","authors":"Naseem Eisa, Omar Barood","doi":"10.1007/s00592-026-02780-8","DOIUrl":"https://doi.org/10.1007/s00592-026-02780-8","url":null,"abstract":"<p><strong>Aims: </strong>The load-capacity index (LCI), defined as the ratio of fat mass to fat-free mass, represents a novel composite biomarker integrating metabolic load and functional capacity. This systematic review and meta-analysis aimed to determine the longitudinal association between LCI and incident cardiometabolic disease risk.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, Cochrane Central, and Scopus from inception through January 2026 for longitudinal cohort studies reporting the association between LCI and cardiometabolic outcomes. Random-effects meta-analysis was performed using the DerSimonian-Laird method. Heterogeneity was assessed using Cochran's Q, τ², and I² statistics. Study-specific log(HR) values and standard errors are reported in the Supplementary Material to enable full reproducibility.</p><p><strong>Results: </strong>Eighteen longitudinal cohort studies comprising 129,777 participants and 5647 cardiometabolic events were included (mean follow-up: 11.4 years). Higher LCI was significantly associated with increased cardiometabolic risk (pooled HR = 1.174, 95% CI: 1.145-1.204; p < 0.0001). There was low between-study heterogeneity (I² = 11.6%; Cochran's Q = 19.22, df = 17, p = 0.3159; τ² = 0.000347). The association was consistent across age groups, sex, and body composition assessment methods (p-interaction > 0.05 for all). LCI provided incremental predictive value beyond established risk factors (NRI: 0.15-0.28; ΔC-statistic: 0.025-0.041).</p><p><strong>Conclusions: </strong>Higher LCI is independently and consistently associated with increased cardiometabolic disease risk across diverse populations (HR = 1.174, corresponding to a 17.4% increased risk per unit increase). LCI provides clinically meaningful incremental predictive value and warrants consideration as a robust supplementary tool to guide preventive interventions.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148885964","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":"Effects of dapagliflozin on proteinuria, glycemic control, and treatment burden in diabetic kidney transplant recipients: a matched cohort study.","authors":"Zeynep Ural, Ulver Derici","doi":"10.1007/s00592-026-02792-4","DOIUrl":"https://doi.org/10.1007/s00592-026-02792-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Diabetes mellitus and persistent proteinuria are major determinants of cardiovascular morbidity, graft dysfunction, and mortality after kidney transplantation. Although sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated substantial cardiorenal benefits in chronic kidney disease, data regarding their use in kidney transplant recipients remain limited. This study aimed to evaluate the clinical effects of dapagliflozin on proteinuria, graft function, glycemic measures, treatment burden, and observed safety events in diabetic kidney transplant recipients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted an exploratory retrospective 1:1 clinically matched cohort study of diabetic kidney transplant recipients followed between 2010 and 2022. Among 282 transplant recipients, 68 had diabetes mellitus. Eighteen patients initiated dapagliflozin 10 mg/day and were included in the all-treated tolerability cohort; three discontinued treatment before completing 3 months because of patient preference unrelated to documented adverse events, leaving 15 recipients who received dapagliflozin for at least 12 months in the efficacy cohort. Fifteen diabetic kidney transplant recipients not receiving SGLT2 inhibitor therapy were selected as 1:1 clinically matched comparable controls according to prespecified matching criteria. Primary outcomes were changes in proteinuria and eGFR. Secondary outcomes included HbA1c, fasting plasma glucose, insulin requirements, antihypertensive medication burden, and observed safety events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty diabetic kidney transplant recipients were included in the 12-month efficacy analysis (15 dapagliflozin-treated recipients and 15 1:1 clinically matched comparable controls). Baseline demographic, transplant-related, renal, and glycemic characteristics were broadly comparable between groups. Proteinuria decreased more in the dapagliflozin group than in controls (median change, - 157 [- 310 to - 52] vs. -12 [- 48 to + 25] mg/day; Hodges-Lehmann location-shift estimate, - 171 mg/day; 95% CI, - 310 to - 32; p = 0.009), while eGFR remained stable (between-group difference in ΔeGFR, + 1.6 mL/min/1.73 m²; 95% CI, - 1.8 to + 5.0; p = 0.31). HbA1c decreased from 8.10% (65 mmol/mol) to 7.10% (54 mmol/mol) in the dapagliflozin group, whereas it decreased from 8.18% (66 mmol/mol) to 7.80% (62 mmol/mol) in controls. Greater reductions were also observed in fasting plasma glucose and daily insulin dose. Two urinary tract infections requiring oral antibiotics occurred in the dapagliflozin group and one in controls. No genital infections, diabetic ketoacidosis, acute rejection, graft loss, cardiovascular events, severe infections requiring hospitalization, or deaths were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this exploratory 1:1 clinically matched cohort of selected diabetic kidney transplant recipients, dapagliflozin use was associated with reduced proteinuria, improved glycemi","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863432","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":"Exploring the therapeutic response to sodium-glucose cotransporter-2 inhibition in INSR-related insulin resistance monogenic diabetes: case-based analysis and narrative review.","authors":"David Franklin, Jan Mahony, Chirag Patel, Jessica Triay","doi":"10.1007/s00592-026-02795-1","DOIUrl":"https://doi.org/10.1007/s00592-026-02795-1","url":null,"abstract":"<p><strong>Background: </strong>INSR-related insulin resistance is a form of monogenic diabetes caused by pathogenic variants in the INSR gene, resulting in impaired insulin receptor signalling and a spectrum of insulin resistance. Conventional diabetes management strategies relying on insulin sensitisation or augmentation are often less effective and evidence to guide treatment in those with heterozygous INSR mutations remains limited.</p><p><strong>Index case analysis: </strong>A 63-year-old male diagnosed with type 2 diabetes aged 40 presented with a relatively stable fasting glucose and disproportionate postprandial hyperglycaemia despite prandial insulin. He had bilateral asymmetric mixed hearing loss (conductive/sensorineural) and early cardiovascular disease. C-peptide was preserved at 1.3 nmol/L with serum glucose at 7.1 mmol/L. Monogenic diabetes genetic testing identified a heterozygous likely pathogenic variant (i.e. mutation) in INSR (c.3473G > A, (p.Arg1158Gln)). Treatment with a sodium-glucose cotransporter-2 inhibitor (SGLT2 inhibitor) achieved 78% time-in-range (TIR). Subsequent SGLT2 inhibitor withdrawal for four months due to pyelonephritis led to TIR deterioration to 2% despite intensified basal insulin. Berberine initiation produced modest improvement (TIR 24%). Following re-introduction of the SGLT2 inhibitor, TIR rapidly improved to 85%, with restoration of a stable overnight profile.</p><p><strong>Literature review: </strong>A narrative review identified eight cases with INSR-related insulin resistance (Donohue/Rabson-Mendenhall/type A insulin resistance) treated with a SGLT2 inhibitor. All reports documented clinically meaningful HbA1c reductions (1.4-3.6%) and, where available, improved CGM metrics.</p><p><strong>Conclusions: </strong>SGLT2 inhibitors provide insulin-independent glycaemic benefit in INSR-related insulin resistance. AMPK-activating strategies, including metformin, berberine, and exercise, may provide adjunctive benefit via cellular glucose uptake, although evidence remains limited. We propose a two-factor therapeutic framework targeting (1) insulin-independent glucosuria and (2) AMPK-mediated glucose uptake as a rational management approach for this rare form of diabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872507","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":"Advanced hybrid closed-loop therapy for type 1 diabetes in a correctional facility: a real-world case series.","authors":"Valentina Anelli, Cristina Cairone, Federico Bertuzzi, Elisa Muratore, Alessandro Viadana, Angelo Vincenzo Cornaghi, Basilio Pintaudi","doi":"10.1007/s00592-026-02793-3","DOIUrl":"https://doi.org/10.1007/s00592-026-02793-3","url":null,"abstract":"<p><strong>Background: </strong>Management of type 1 diabetes (T1D) in correctional facilities is challenging due to limited autonomy, restricted access to technologies, and non-flexible daily routines.</p><p><strong>Objective: </strong>To evaluate the feasibility and short-term glycemic outcomes of advanced hybrid closed-loop (aHCL) systems in individuals with T1D in a correctional setting.</p><p><strong>Methods: </strong>We conducted a retrospective real-world case series including adults with T1D incarcerated in a correctional facility and initiated on an advanced hybrid closed-loop (aHCL) system. Glycemic metrics were assessed at baseline and after 3 months. Continuous variables are reported as median (IQR). Paired comparisons were performed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Six individuals were included and five completed follow-up. Median HbA1c decreased from 9.7% to 7.8% (p = 0.043). Median time in range (TIR) increased from 41% to 49%, while time below range (TBR) and time above range (TAR) decreased from 0.5% to 0% and from 57.5% to 43%, respectively, although these changes were not statistically significant. No severe hypoglycemia or diabetic ketoacidosis events occurred.</p><p><strong>Conclusions: </strong>Use of aHCL systems in a correctional setting was feasible and associated with improved HbA1c without increased hypoglycemia. These findings support the potential role of advanced diabetes technologies in restricted environments.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863268","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":"Myosteatosis is associated with adverse in-hospital outcomes and CONUT score in hospitalized internal medicine patients.","authors":"Nicoletta Miano, Maurizio Di Marco, Sabrina Scilletta, Giorgia Todaro, Giosiana Bosco, Francesco Di Giacomo Barbagallo, Roberto Scicali, Salvatore Piro, Antonino Di Pino","doi":"10.1007/s00592-026-02785-3","DOIUrl":"https://doi.org/10.1007/s00592-026-02785-3","url":null,"abstract":"<p><strong>Aims: </strong>Myosteatosis is a marker of malnutrition and of adverse clinical outcomes and diabetes is among its contributors. Currently, no single universally accepted method exists to screen for malnutrition, but COntrolling NUTritional status (CONUT) score seems to be promising. This study aimed to assess the impact of myosteatosis on in-hospital outcomes and to test its association with CONUT score in people with and without type 2 diabetes.</p><p><strong>Methods: </strong>227 patients aged > 40 years admitted to an Internal Medicine Department were consecutively recruited, recording in-hospital outcomes. Myosteatosis was assessed as multifidus muscle to subcutaneous fat (MM/F) attenuation ratio at computed-tomography scan. CONUT was calculated using albumin, lymphocyte count and total cholesterol. The population was stratified, based on sex-differentiated tertiles of MM/F, in a low myosteatosis group (n = 152) and a high myosteatosis group (n = 75; top tertile of MM/F).</p><p><strong>Results: </strong>The high myosteatosis group showed a higher prevalence of in-hospital death (12.5 vs. 26%, P < 0.001) and pneumonia. Moreover, the high myosteatosis group experienced a longer length-of-stay and was more likely to have cultures positive for multi-drug-resistant germs. In-hospital death was independently associated with MM/F ratio (OR 2.74, 95%CI 1.11-7.75, P = 0.035). Diabetes did not show significant interaction on this association (P-for-interaction = 0.43). From multiple regression model, MM/F was independently associated with CONUT (β = 0.30, P < 0.001).</p><p><strong>Conclusions: </strong>Myosteatosis was associated with adverse in-hospital outcomes. CONUT score was independently associated with the imaging-derived MM/F ratio. Further studies specifically designed to evaluate diagnostic performance are required before CONUT can be proposed as a screening tool for myosteatosis.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863443","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}