Frontiers in clinical diabetes and healthcare最新文献

{"title":"Observational studies on the association of outpatient antidiabetic medication use and COVID-19 outcomes: are the findings more relevant to diabetes management than to COVID-19 pathology? A mini-review.","authors":"Jelena Dimnjaković, Tamara Buble, Ognjen Brborović","doi":"10.3389/fcdhc.2026.1760695","DOIUrl":"10.3389/fcdhc.2026.1760695","url":null,"abstract":"<p><p>At the start of the COVID-19 pandemic, there were concerns that some antidiabetic medications might worsen outcomes, though anti-inflammatory properties suggested possible benefits. Many observational studies examined antidiabetic medications use and COVID-19 outcomes. Meta-analyses showed that insulin was linked to worse outcomes, while metformin, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and glucagon-like peptide-1 (GLP-1) agonists were associated with better outcomes. Findings on dipeptidyl peptidase-4 (DPP-4) inhibitors, pioglitazone, and sulfonylureas were mixed-showing neutral, beneficial, or negative effects. However, randomized controlled trials (RCTs) testing these medications after SARS-CoV-2 infection found no effect on COVID-19 outcomes, implying that their anti-inflammatory effects do not translate into meaningful clinical benefits during acute infection. This discrepancy prompts questioning what observational studies actually measured. Given that many studies applied robust statistical methods, their results are unlikely solely due to confounding or indication bias. We hypothesize that these studies reveal broader cardiovascular effects and illuminate diabetes management more than they inform COVID-19 pathology. Their findings align with current 2022 American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) consensus guidelines for the management of type 2 diabetes mellitus endorsing metformin, SGLT-2 inhibitors, and GLP-1 agonists as first-line therapies, recommending cautious early insulin use, and reserving DPP-4 inhibitors, sulfonylureas, and pioglitazone for selective cases. This is applicable regardless of COVID-19 status. Further research should determine whether infection-related clinical endpoints, such as mortality or hospitalization from COVID-19 or other infections, might serve as valid surrogate markers for cardiovascular outcomes.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1760695"},"PeriodicalIF":3.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of chromogranin A cleavage products in onset of type 1 and 2 diabetes.","authors":"Gustaf Christoffersson, Elke M Muntjewerff","doi":"10.3389/fcdhc.2026.1812936","DOIUrl":"10.3389/fcdhc.2026.1812936","url":null,"abstract":"<p><p>Chromogranin A (CgA) is a pro-hormone widely expressed in neuroendocrine tissues and elevated in both type 1 (T1D) and type 2 diabetes (T2D). Its diverse biological effects arise from proteolytic cleavage into six bioactive peptides: vasostatin I and II (VS-I/II), chromofungin (CHR), pancreastatin (PST), catestatin (CST), WE-14, and serpinin-each exerting distinct and sometimes opposing functions. This review covers current knowledge on the activity, circulating levels, and mechanistic roles of these peptides in diabetes pathogenesis and progression. Evidence indicates contrasting peptide profiles in T1D and T2D: PST levels are elevated in T2D and promote inflammation, gluconeogenesis, and insulin resistance, whereas CST levels are reduced and exert anti-inflammatory and insulin-sensitizing effects. In T1D, CST and VS-I are increased early after diagnosis, with VS-I and WE-14 functioning as autoantigens that drive autoreactive T cell responses. Knockout mouse models further demonstrate that loss of CgA or CST profoundly alters glucose homeostasis, macrophage polarization, catecholamine release, and diabetes susceptibility. Emerging data highlight a complex nerve-immune-endocrine axis through which CgA peptides regulate metabolic and inflammatory pathways. Collectively, CgA-derived peptides represent promising biomarkers and therapeutic targets, though further translational studies remain essential to define their diagnostic and clinical potential.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1812936"},"PeriodicalIF":3.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of GLP-1 receptor agonist therapy in the management of steroid-induced diabetes: a narrative review.","authors":"Aleksandra Jędrasek, Karolina Lisowska, Leszek Czupryniak","doi":"10.3389/fcdhc.2026.1772391","DOIUrl":"10.3389/fcdhc.2026.1772391","url":null,"abstract":"<p><p>Glucocorticosteroids (GCs) are commonly used in the treatment of autoimmune, inflammatory and neoplastic diseases. Although clinically effective, they are associated with significant metabolic side effects, including increased insulin resistance, impaired function of pancreatic <i>β</i>-cells, and, finally, weight gain. These effects can result in steroid-induced hyperglycemia (SIH) and steroid-induced diabetes (SID), both of which increase the risk of complications such as infections and prolonged hospitalisation. Intensive insulin therapy remains the standard treatment for SID. However, emerging evidence suggests that glucagon-like peptide 1 receptor agonists (GLP-1 RAs) may have therapeutic potential to counteract the metabolic effects of steroids. This review evaluates the efficacy and safety of GLP-1 RAs for the treatment of SIH and SID.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1772391"},"PeriodicalIF":3.5,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes zoster hospitalization as a sentinel signal for undiagnosed dysglycemia: a call for routine glycemic screening in clinical practice.","authors":"Tao Xu, Keying Ji, Xi Pu, Shuangmeng Mou","doi":"10.3389/fcdhc.2026.1732223","DOIUrl":"10.3389/fcdhc.2026.1732223","url":null,"abstract":"<p><strong>Background: </strong>Although diabetes mellitus (DM) is an established risk factor for herpes zoster (HZ), the prevalence of undiagnosed dysglycemia in hospitalized HZ patients, and its association with HZ severity, are not well characterized. This study investigated the prevalence of newly identified diabetes and prediabetes in a cohort of patients hospitalized for HZ, comparing those with disseminated and localized presentations.</p><p><strong>Methods: </strong>A retrospective cohort analysis of 564 hospitalized patients with HZ from 2020 to 2024 after exclusion was performed. The patients were divided into localized and disseminated HZ groups based on their clinical presentation. Diabetes was diagnosed on the basis of the 2023 American Diabetes Association (ADA) criteria. Multivariable logistic regression was used to identify independent risk factors for diabetes.</p><p><strong>Results: </strong>Among 564 hospitalized HZ patients, 45 were diagnosed with disseminated HZ. Disseminated HZ was associated with a significantly higher prevalence of newly identified diabetes (22.2% [10/45] vs. 11.9% [62/519], P = 0.048) and prediabetes (33.3% [15/45] vs. 13.1% [68/519], P<0.001), as well as poorer chronic glycemic control (median HbA1c 8.90% vs. 7.50%, P = 0.021).Multivariable logistic regression model confirmed disseminated HZ as an independent predictor of diabetes (adjusted OR = 2.06, 95% CI 1.15-3.69), alongside age >60 years and BMI >25 kg/m². Elevated LDL-C and triglycerides were also significant independent risk factors.</p><p><strong>Conclusion: </strong>Our study identifies disseminated HZ as a key sentinel for previously unrecognized dysglycemia. Routine glycemic screening should be integrated into admission protocols for all hospitalized HZ patients, particularly for severe cases.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1732223"},"PeriodicalIF":3.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of being grandparents of children living with type 1 diabetes in Sweden: a qualitative interview study.","authors":"Åsa Carlsund, Sara Olsson, Åsa Hörnsten","doi":"10.3389/fcdhc.2026.1763046","DOIUrl":"10.3389/fcdhc.2026.1763046","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to describe the perceptions of being grandparents of a grandchild living with type 1 diabetes.</p><p><strong>Introduction: </strong>When a child develops a lifelong condition, it affects the whole family, and caring for a child with chronic illness can be stressful. This ongoing stress can impact family relationships. In addition to parents, siblings and grandparents are often among the first to learn about the child's condition and may be the initial source of support.</p><p><strong>Methods: </strong>Individual interviews were conducted with 11 grandparents from northern Sweden who met the inclusion criteria of having a grandchild with type 1 diabetes. The data were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>The analysis of the interviews uncovered one main theme: being the lighthouse that lights up dark paths but still needing attention to keep shining. Two themes emerged: facing and managing the unknown and balancing expectations and personal needs. Each theme included three subthemes: understanding an emotionally overwhelming situation, taking on new responsibilities and pushing boundaries, and using but not fully trusting self-management technologies. Other aspects included handling a growing pile of concerns, trying to keep the family united, and maintaining personal activities.</p><p><strong>Conclusion: </strong>Grandparents play an essential role in families with children who have type 1 diabetes. They assume significant responsibilities by learning self-management technologies and providing emotional and practical support, which are vital for family stability and the child's well-being. However, this role presents challenges, such as fears of making mistakes in diabetes management and worries about their child's and grandchild's struggles. Despite these challenges, many grandparents show resilience and are eager to support their families. They remain actively involved, primarily relying on informal support and information from their children, partners, or patient organizations.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1763046"},"PeriodicalIF":3.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and associated factors of dry eye disease amongst people diagnosed with diabetes mellitus in Bronkhorstspruit.","authors":"Tlou K Mefane, Cairo B Ntimana, Reneilwe G Mashaba, Eric Mailmela","doi":"10.3389/fcdhc.2026.1760534","DOIUrl":"10.3389/fcdhc.2026.1760534","url":null,"abstract":"<p><strong>Background: </strong>Dry eye disease (DED) is a common ocular surface disorder with a significant impact on quality of life. Its prevalence is higher among individuals with diabetes mellitus (DM), yet limited evidence exists in African settings, particularly in rural communities. Hence, the present study aimed to determine the prevalence and associated factors of DED among individuals living with diabetes in Bronkhorstspruit, South Africa.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between November 2024 and February 2025 among 236 diabetic patients selected through simple random sampling from a public hospital and a private clinic. Standardized diagnostic tests (tear break-up time [TBUT], Schirmer test) and the Ocular Surface Disease Index (OSDI) questionnaire were used to diagnose and grade DED. Socio-demographic and ocular history data were collected. Logistic regression was performed to identify determinants of DED, with results reported as odds ratios (ORs) at 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of the 163 participants analyzed, the prevalence of DED was 81.6%. Prevalence increased with age, with the ≥65 years group most affected (Males: 50.0%; Females: 38.4%). Participants aged ≥45 years were 4.5-9.1 times more likely to develop DED compared to those aged ≤44 years. Females reported higher rates of dryness (24.2%), tearing (10.1%), and itching (6.1%), while males reported more blurry vision (68.8%) and pain (14.1%). Lower educational attainment was associated with a 2.1-fold increased risk of severe DED. Marital status and ocular comorbidities were not significantly associated with DED.</p><p><strong>Conclusion: </strong>The prevalence of DED among individuals living with diabetes in Bronkhorstspruit was 81.6%. An increase with age, female sex, and lower educational attainment were identified as factors significantly associated with DED, whereas marital status was not associated with DED. The high prevalence reported underscores the urgent need for context-specific interventions, including community-level awareness, early screening, and tailored management strategies, to mitigate the ocular complications of diabetes. Future studies should explore environmental exposures as additional risk factors.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1760534"},"PeriodicalIF":3.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of diabetic retinopathy in type-2 diabetes in Pakistan: a systematic review and meta-analysis.","authors":"Sohail Akhtar, Shafiqa Ashraf, Alessandra Buja, Ibrahim Ahmad Khalil, Olayan Albalawi, Fayaz Ahmad, Muhammad Daud Khan, Aqsa Ali","doi":"10.3389/fcdhc.2026.1758759","DOIUrl":"10.3389/fcdhc.2026.1758759","url":null,"abstract":"<p><strong>Aim: </strong>Diabetic retinopathy is one the major complications of type-2 diabetes and a leading cause of blindness and visual impairment in Pakistan. However, there is currently no nationally representative population-based estimate of its prevalence. The objective of this study was to determine the pooled prevalence of diabetic retinopathy in individuals with type-2 diabetes in Pakistan.</p><p><strong>Methods: </strong>We systematically searched MEDLINE (via PubMed), Embase (via Ovid), Web of Science, and local databases from the inception till September 15, 2025. Two independent authors selected studies and conducted the risk of bias analysis. We conducted a random-effects meta-analysis to calculate pooled prevalence. Subgroup analyses and meta-regression analyses were performed in order to explore moderators. Heterogeneity was evaluated incorporating the I² statistic, and robustness of the findings were evaluated from leave-one-out sensitivity analyses. Publication bias was assessed through funnel plots, Begg's test, and Egger's test.</p><p><strong>Results: </strong>In total, 60 studies including 45,646 patients with type-2 diabetes were included in the analysis. The pooled prevalence of diabetic retinopathy was 32.9% (95%CI: 27.67-38.40). Across all studies the 95% prediction interval was wide (2.42-76.28), indicating high level of between-study heterogeneity (I² = 98.8%). There was no evidence of publication bias from Begg's (p = 0.818) or Egger's test (p = 0.098). Subgroup analysis by region showed a significant difference (p = 0.0001) in the prevalence of diabetic retinopathy by region, Balochistan 54.65%, Khyber Pakhtunkhwa 47.55%, Punjab 30.60%, Sindh 29.75%, and Islamabad 14.73%. There was a significant time trend (p = 0.034) with increased prevalence of diabetic retinopathy over time, increasing from 21.32% (2001-2009) to 29.31% (2010-2019) and then to 39.59% (2020-2025).</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis found a high prevalence of diabetic retinopathy in Pakistan with significant heterogeneity among studies. These results substantiate the need for timely screening and management of patients with diabetic retinopathy.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024530689, identifier CRD42024530689.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1758759"},"PeriodicalIF":3.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a risk prediction model of delayed onset of lactogenesis among mothers with gestational diabetes mellitus: a prospective multicenter study.","authors":"Yu-Ting Luo, Min Xu, Zhi-Dong Guo, Yun-Xia Liu, Li Liu","doi":"10.3389/fcdhc.2026.1721649","DOIUrl":"10.3389/fcdhc.2026.1721649","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to develop and validate a prediction model of delayed onset of lactogenesis among mothers with gestational diabetes mellitus.</p><p><strong>Methods: </strong>This was a prospective study. A total of 511 mothers with GDM hospitalized at seven tertiary (grade 3A) hospitals in five cities of Guangdong Province, China, between October 10, 2023, and December 8, 2024, were enrolled in the study using convenience sampling. Univariate regression, LASSO regression and logistic regression were used to construct and validation risk prediction model. Logistic regression and R language was used to draw the nomogram. Model performance was evaluated using the area under the receiver operator characteristic curve (AUC), Hosmer-Lemeshow goodness-of fit test, and clinical decision curve analysis, assessing the discrimination ability, calibration, and clinical utility of the model.</p><p><strong>Results: </strong>Based on logistic regression analysis, we identified several significant delayed onset of lactogenesis risk factors for mothers with gestational diabetes mellitus: pre-delivery BMI, Edinburgh Postnatal Depression Scale score, serum albumin levels, LATCH score, blood glucose control during pregnancy. The AUC was 0.828, (95%<i>CI</i>:0.779~0.877),with a sensitivity of 70.9%, a specificity of 83.7%,optimal cut-off point of 0.341, a maximum Youden index of 0.546. The Hosmer-Lemeshow test yielded a <i>χ</i> ² value of 7.226 and <i>p</i> = 0.546.The internal verification showed the AUC was 0.806(95%<i>CI</i>:0.728, 0.884), indicating the model's high discrimination ability. Calibration curves showed good agreement between predicted and observed values, confirming good calibration. The clinical decision curve analysis further supported the model's clinical utility.</p><p><strong>Conclusion: </strong>The prediction model constructed and verified in this study was to predict delayed onset of lactogenesis risk for mothers with gestational diabetes mellitus, providing an effective evaluation tool for healthcare professionals.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1721649"},"PeriodicalIF":3.5,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between triglyceride-glucose (TyG) index and diabetic foot ulcers in adult inpatients with type 2 diabetes at hospital admission.","authors":"Alessandro De Stefano, Donatella Pastore, Marco Infante, Francesca Pacifici, Carmine Cardillo, Manfredi Tesauro, Francesca Schinzari, Federica Fazio, Massimiliano Caprio, Alessandro Terrinoni, Laura Di Renzo, Antonino De Lorenzo, Giulia Donadel, David Della-Morte","doi":"10.3389/fcdhc.2026.1733439","DOIUrl":"10.3389/fcdhc.2026.1733439","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes mellitus. Over the last years, the triglyceride-glucose (TyG) index has emerged as a surrogate marker of insulin resistance. We previously conducted a retrospective study on Albanian adult inpatients with type 2 diabetes (T2D), in which we showed that circulating triglycerides and fasting plasma glucose at hospital admission were among the most relevant independent variables associated with an increased risk of DFU in this population.</p><p><strong>Materials and methods: </strong>The present dual-center, retrospective case-control study assessed the relationship between the TyG index and the presence of DFU in a cohort of 497 adult inpatients (295 males; 202 females) with T2D, who were consecutively admitted to two Hospitals during different periods between 2014 and 2023. Patients with DFUs served as cases (DFU group; n=106), while patients without DFUs served as controls (non-DFU group; n=391).</p><p><strong>Results: </strong>Mean TyG index values were significantly higher in the DFU group than in the non-DFU group (5.02 ± 0.15 vs. 4.98 ± 0.09; p<0.001). Mean TyG-body mass index (BMI) index (TyG-BMI index) values were also significantly higher in the DFU group than in the non-DFU group (133.7 ± 23.5 vs. 126 ± 20.0; p=0.004). Based on the receiver operating characteristic (ROC) curve analysis, the TyG index showed a significant discriminative ability for the prediction of DFU (AUC = 0.61; 95% CI: 0.54-0.68; p<0.001), with a sensitivity of 38% and a specificity of 92% at the cut-off point of >5.08. In the multivariate logistic regression models, the TyG index was independently associated with the presence of DFU at hospital admission: odds ratio (OR) = 2.18; 95% confidence interval (CI): 1.68-2.83; p<0.0001 [model 2]; OR = 1.86; 95% CI: 1.27-2.71; p=0.001 [model 3].</p><p><strong>Conclusions: </strong>In conclusion, our study suggests that the TyG index may represent a valid prognostic biomarker among adult inpatients with T2D. Large prospective studies are needed to better clarify the predictive value of the TyG index for DFU, as well as its role as a marker of DFU severity among adult inpatients and outpatients with T2D.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1733439"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking inflammation, metabolic dysfunction, and neurodegeneration: a comprehensive review of TLR2 pathways in type 2 diabetes.","authors":"Juan Antonio Arreguín-Cano, Sandra Aidé Santana-Delgado, Carlos Esteban Villegas-Mercado, Grissel Guadalupe Orozco-Molina, Adolfo González-Acosta, Mercedes Bermúdez","doi":"10.3389/fcdhc.2026.1791782","DOIUrl":"10.3389/fcdhc.2026.1791782","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder increasingly recognized as a systemic inflammatory condition with significant neurological effects. Growing evidence shows that chronic low-grade inflammation (CLGI), insulin resistance, and metabolic imbalance contribute to cognitive decline and the development of neurodegenerative diseases like Alzheimer's and Parkinson's. Toll-like receptor 2 (TLR2), a critical pattern-recognition receptor of the innate immune system, has emerged as an essential molecular link between metabolic dysfunction and neuroinflammation and neuronal damage. This review summarizes current experimental, clinical, and translational evidence on the role of TLR2 in T2DM-related inflammation, mitochondrial dysfunction, lipid imbalance, insulin resistance, and blood-brain barrier (BBB) issues. We explore how ongoing TLR2 activation by internal danger signals and metabolic stressors maintains systemic inflammation and fuels neuroimmune responses via microglial activation and cytokine release, thereby accelerating neurodegenerative processes. Additionally, we discuss new therapeutic strategies targeting TLR2 signaling, including drugs, dietary supplements, and the repurposing of antidiabetic medications with neuroprotective effects. By combining immunometabolic and neurodegenerative pathways, this review highlights TLR2 as a promising target for preventing or reducing diabetes-related cognitive decline neurodegeneration.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1791782"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}