Acta Diabetologica最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune hyperglycemia: beyond type 1 diabetes.","authors":"Irene Rutigliano, Francesco Gallo, Grazia Fini, Morena Mansueto, Vincenzo Trischitta, Rosa Di Paola","doi":"10.1007/s00592-025-02506-2","DOIUrl":"https://doi.org/10.1007/s00592-025-02506-2","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune polyglandular syndrome type 1 (APS1) is characterized by chronic mucocutaneous candidiasis, hypoparathyroidism and autoimmune adrenal insufficiency and sporadically by other autoimmune conditions including thyroiditis and diabetes mellitus. APS1 is usually caused by recessive mutations in the AIRE gene, though rare dominant mutations can result in mild, late-onset clinical manifestations. Whether and to what extent autoimmune diabetes is present in these latter forms has been poorly addressed.</p><p><strong>Methods: </strong>Genetic testing for monogenic diabetes in an Italian child with early onset diabetes (at the age of 18 months), positive IA2 antibodies and negative insulin GAD antibodies was performed by Next Generation Sequencing, using direct Sanger sequencing as a confirmatory test.</p><p><strong>Results: </strong>A heterozygous AIRE inframe likely pathogenic deletion (c.64_69del, p.Val22_Asp23del, rs752303080 in exon 1; NM_000383.4) was identified. The proband's father carried the same AIRE mutation and presented with subclinical hypothyroidism and coeliac disease but normal glucose level.</p><p><strong>Conclusions: </strong>To the best of our knowledge this is the first case of early onset diabetes as the only autoimmune manifestation related to AIRE heterozygous variants. In a broader context, our report indicates the need for genetic testing in individuals with isolated autoimmune hyperglycemia whose very early onset makes the diagnosis of type 1 diabetes unlikely. Our finding also highlights the heterogeneity of clinical expression of AIRE heterozygous variants, with two carriers of the same pedigree showing different organs involved and age of disease onset, in the absence of the most typical APS1 clinical abnormalities.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054009","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":"Relationship between liver fat, pancreatic fat, and new-onset type 2 diabetes mellitus in patients with metabolic dysfunction-associated fatty liver disease.","authors":"Huanjia Qu, Lingling Zhou, Dong Tang, Qiuling Zhang, Pu Yang, Boyi Yang, Junping Shi","doi":"10.1007/s00592-025-02501-7","DOIUrl":"https://doi.org/10.1007/s00592-025-02501-7","url":null,"abstract":"<p><strong>Purpose: </strong>Type 2 diabetes mellitus (T2DM) is associated with ectopic fat deposition, especially in the liver and pancreas. Therefore, this study aimed to evaluate the relationship between liver fat fraction (LFF), pancreatic fat fraction (PFF), and new-onset T2DM in metabolic dysfunction-associated fatty liver disease (MAFLD) by magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>This is a retrospective study of patients with MAFLD who underwent abdominal MRI between 2022 and July 2024. LFF and PFF were measured using an axial multi-echo Dixon-based sequence. All participants underwent routine medical history, anthropometric measurements, and laboratory tests. Multivariable stepwise selection models were constructed to predict PFF and T2DM status based on variables of clinical interest.</p><p><strong>Results: </strong>This study included 80 MAFLD patients with 40 untreated new-onset T2DM and 40 non-T2DM controls. LFF, PFF, and homeostasis model assessment of insulin resistance (HOMA-IR) index were higher in the T2DM group than in the control group. In the new-onset T2DM group, PFF was linearly positively correlated with LFF (r_s = 0.321, P = 0.04) and HOMA-IR (r_s = 0.350, P = 0.03). After adjustment for several metabolic variables, PFF remained an independent risk factor for incident T2DM in MAFLD patients (all P < 0.05). The area under the receiver operating characteristic curve for PFF and LFF to predict T2DM was 0.889 and 0.633 (P < 0.001 and P = 0.03), respectively.</p><p><strong>Conclusion: </strong>In MAFLD patients, PFF, and LFF play a prominent role in new-onset T2DM with high predictive and diagnostic value.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958351","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":"DKA in a toddler negative to type 1 diabetes autoantibodies: unusual presentation of Kearn-Sayre syndrome.","authors":"Annalisa Deodati, Novella Rapini, Diego Martinelli, Mafalda Mucciolo, Rosalba Carozzo, Riccardo Schiaffini, Stefano Cianfarani, Fabrizio Barbetti","doi":"10.1007/s00592-025-02509-z","DOIUrl":"https://doi.org/10.1007/s00592-025-02509-z","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958324","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 stress hyperglycemia ratio and acute kidney injury in patients with chronic cardiovascular-kidney disorder: a multi-center retrospective cohort study from China.","authors":"Yihang Ling, Yibo He, Tian Chang, Xianlin Ruan, Huangtao Ruan, Zeliang Li, Jin Liu, Yong Liu, Jiyan Chen","doi":"10.1007/s00592-025-02493-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02493-4","url":null,"abstract":"<p><strong>Aim: </strong>Stress hyperglycemia ratio (SHR) is associated with acute kidney injury (AKI) among patients with myocardial infarction. However, the relationship between SHR and AKI in chronic cardiovascular-kidney disorder (CCV-KD) patients are still unknown. This study aimed to clarify the association of SHR with adverse renal outcomes in CCV-KD patients.</p><p><strong>Method: </strong>6,359 CCV-KD patients from the Chinese multi-center registry cohort Cardiorenal ImprovemeNt II (CIN-II) were included in this study. We categorized SHR into distinct groups and conducted logistic analyses to evaluate its association with AKI and progression to end-stage kidney disease (ESKD) or in-hospital dialysis. We also calculated the incidence of these adverse renal outcomes, stratified by estimated glomerular filtration rate (eGFR). Additionally, restricted cubic spline (RCS) was performed to understand the relationship between SHR and adverse renal outcomes.</p><p><strong>Result: </strong>In this study, 13.7% patients experienced AKI and 4.3% patients progressed to ESKD or in-hospital dialysis. Both low SHR (< 0.7) and high SHR (≥ 1.1) were associated with a significantly increased risk of AKI. In addition, high SHR was strongly correlated with an increasing risk of progression to ESKD/dialysis during hospitalization. The incidence of AKI was lowest when the SHR was between 0.9 and 1.1, while the incidence of ESKD was highest when the SHR was ≥ 1.1, across all eGFR subgroups.</p><p><strong>Conclusion: </strong>In patients with CCV-KD, both low and high SHR are associated with an increased risk of AKI development, and elevated SHR is associated with the risk of ESKD/dialysis as well.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959314","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":"Enhancing self-care management in diabetic patients: a randomized controlled trial exploring the interplay of social support, self-efficacy, and empowerment.","authors":"Nevin F Ibrahim, Hanaa A Nofal, Hossam Tharwat Ali, Dina S El-Rafey, Noura Almadani, Rasha Mahfouz, Reda M Khodary","doi":"10.1007/s00592-025-02498-z","DOIUrl":"https://doi.org/10.1007/s00592-025-02498-z","url":null,"abstract":"<p><strong>Background: </strong>Despite the significant global and Egyptian prevalence of Type 2 Diabetes Mellitus (T2DM), with the recognized importance of self-care and social support in enhancing glycemic control, there is a scarcity of studies on this topic within Egypt's especially interventional studies and role of enhancement program on diabetic self-management practice. Our objective is to evaluate the effect of a health education program on the enhancement of self-care management compared to the usual care and explore factors affecting self-care management as social support, self-efficacy, and empowerment among patients with T2DM.</p><p><strong>Methods: </strong>A randomized control trial was conducted on 330 (165:165) T2DM patients confirmed more than one year and had regular visits to the diabetic patient clinic in our hospital. The study outcomes include diabetes knowledge, self-management practice, social support, self-efficacy, and empowerment along with body mass index (BMI), glycated hemoglobin (HbA1c), and fasting blood glucose (FBG).</p><p><strong>Results: </strong>The intervention group had significant improvements in knowledge and self-practice with post-intervention adequate values (80.0% and 87.8%) compared to the control (40% and 55.1%) respectively (p-value < 0.001). Furthermore, a significant increase in patients with controlled FBG and HbA1c occurred in both groups (p-value < 0.001) with a significantly higher increase in the intervention group (p-value < 0.001). In total, 60.9%, 58.8%, and 25.7% of the patients had satisfactory social support, self-efficacy, and empowerment, respectively.</p><p><strong>Conclusion: </strong>The results indicated that a diabetes self-care management education program was proven to be effective in improving patients' self-care management. Social support, self-efficacy, and empowerment could have positive roles.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952578","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":"Primary cutaneous B-cell lymphoma in a woman with type 2 diabetes: a case report.","authors":"Enzo de Araujo Melo, Sarah Lopes Salomão, Bruna Pinheiro Lourente, Carlos Antonio Negrato","doi":"10.1007/s00592-025-02489-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02489-0","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959292","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":"Glial fibrillary acidic protein: a potential biomarker for small fiber neuropathy?","authors":"Claus Vinter Bødker Hviid, Nicklas Højgaard-Hessellund Rasmussen, Johan Røikjer","doi":"10.1007/s00592-025-02500-8","DOIUrl":"https://doi.org/10.1007/s00592-025-02500-8","url":null,"abstract":"<p><strong>Background: </strong>Objective and easily applicable biomarkers for diabetic polyneuropathy (DPN) are warranted. Circulating nerve-specific proteins have emerged as valuable biomarkers for central nervous system disease but few of these have been tested in peripheral neuropathy. Glial Fibrillary Acidic Protein (GFAP) is highly expressed in non-myelinating Schwann cells while UCH-L1 is a neuron expressed stress protein not previous analyzed in DPN. In this pilot study, we explore serum GFAP and UCH-L1 levels in patients with/without DPN and controls.</p><p><strong>Methods: </strong>Persons with DPN (n = 28), without DPN (n = 31), and controls (n = 30) were evaluated in a cross-sectional design. Sural nerve conduction (velocity and amplitude) was evaluated by NC-stat DPNCheck™ and quantitative sensory testing of cold detection and pain was performed. GFAP and UCH-L1 levels were compared across study groups and the unadjusted correlation with nerve assessments evaluated.</p><p><strong>Results: </strong>Serum GFAP were lower in persons with DPN (20.9 ± 10.9 pg/ml) than in persons without DPN (26.2 ± 14.1 pg/ml) (p = 0.04) or controls (31.7 ± 26.0 pg/ml) (p = 0.02). GFAP levels were not different in persons without DPN and controls (p = 0.61). UCH-L1 levels were not different between study groups (p = 0.48). GFAP levels correlated with cold pain threshold (Rho= - 0.320, p = 0.02) but failed to reach significance for cold detection (Rho= - 0.236, p = 0.09). No correlation was observed between GFAP and nerve amplitude (p = 0.58) or conductivity (p = 0.86).</p><p><strong>Conclusion: </strong>Serum GFAP levels are reduced in persons with DPN compared to persons without DPN and controls. Reduced serum GFAP levels may be associated with reduced markers of small nerve fiber damage obtained from quantitative sensory testing in people with diabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794334","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":"Increasing HbA1c in children and youth with a first-degree relative with type 1 diabetes predicts progression to diabetes: a single-centre 10-year screening experience.","authors":"Claudia Piona, Giovanna Contreas, Susanna Gobbi, Erika Caiazza, Costantini Silvia, Elisa Morotti, Marco Marigliano, Claudio Maffeis","doi":"10.1007/s00592-025-02477-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02477-4","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778641","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 the triglyceride glucose-body roundness index and the incidence of cardiovascular disease among Chinese middle and old-aged adults: a nationwide prospective cohort study.","authors":"Wangyang Bai, Hangqi Chen, Huiqin Wan, Xiaofei Ye, Yi Ling, Jinfang Xu, Xiaojing Guo, Jia He","doi":"10.1007/s00592-025-02499-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02499-y","url":null,"abstract":"<p><strong>Aim: </strong>Previous studies have suggested that the triglyceride glucose (TyG) index and body roundness index (BRI) are indicators of insulin resistance (IR) and are associated with the incidence of cardiovascular disease (CVD) among middle and old-aged adults. BRI is considered a more accurate indicator of the proportion of body fat and visceral fat than body mass index (BMI). However, it remains unclear whether the combined use of the TyG index and BRI, specifically the triglyceride glucose-body roundness index (TyG-BRI), is associated with the incidence of CVD among Chinese middle and old-aged adults.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The TyG-BRI index was computed using baseline measurements of triglycerides, fasting blood glucose, waist circumference, and height. Cox proportional hazards regression and restricted cubic spline (RCS) regression analyses were applied to assess the association between the TyG-BRI index and incident CVD (defined as cardiac events or stroke).</p><p><strong>Results: </strong>A total of 8,113 Chinese adults participated in this study, with a median age of 58 years, including 56.3% males. The fully adjusted Cox regression analysis revealed that individuals in the highest quartile (Q4) of the TyG-BRI index had a 59.1% increased risk of developing incident CVD compared to those in the lowest quartile (HR, 1.591 [95% CI, 1.330-1.902]). The TyG-BRI index showed a significant linear association with CVD incidence (P for nonlinearity = 0.447, P < 0.001). This association persisted after conducting subgroup and sensitivity analyses.</p><p><strong>Conclusions: </strong>This study introduced a novel TyG-BRI index, which integrated IR and body roundness as a comprehensive indicator, demonstrating its strong and independent association with increased CVD risk in a Chinese nationwide cohort. Our findings provide new insights into the interaction between metabolic dysfunction and cardiovascular risk, suggesting that the TyG-BRI index could serve as a practical tool for targeted preventive interventions.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750224","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}