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Diabetologia Jul 2024An association between diabetes and infection has been recognised for many years, with infection being an important cause of death and morbidity in people with diabetes.... (Review)
Review
An association between diabetes and infection has been recognised for many years, with infection being an important cause of death and morbidity in people with diabetes. The COVID-19 pandemic has re-kindled an interest in the complex relationship between diabetes and infection. Some infections occur almost exclusively in people with diabetes, often with high mortality rates without early diagnosis and treatment. However, more commonly, diabetes is a complicating factor in many infections. A reciprocal relationship occurs whereby certain infections and their treatments may also increase the risk of diabetes. People with diabetes have a 1.5- to 4-fold increased risk of infection. The risks are the most pronounced for kidney infection, osteomyelitis and foot infection, but are also increased for pneumonia, influenza, tuberculosis, skin infection and general sepsis. Outcomes from infection are worse in people with diabetes, with the most notable example being a twofold higher rate of death from COVID-19. Hyperglycaemia has deleterious effects on the immune response. Vascular insufficiency and neuropathy, together with altered skin, mucosal and gut microbial colonisation, contribute to the increased risk of infection. Vaccination is important in people with diabetes although the efficacy of certain immunisations may be compromised, particularly in the presence of hyperglycaemia. The principles of treatment largely follow those of the general population with certain notable exceptions.
Topics: Humans; COVID-19; Diabetes Mellitus; SARS-CoV-2; Diabetes Complications; Infections
PubMed: 38374451
DOI: 10.1007/s00125-024-06102-x -
Frontiers in Immunology 2023Diabetes mellitus is a metabolic disease that is characterized by chronic hyperglycemia due to a variety of etiological factors. Long-term metabolic stress induces... (Review)
Review
Diabetes mellitus is a metabolic disease that is characterized by chronic hyperglycemia due to a variety of etiological factors. Long-term metabolic stress induces harmful inflammation leading to chronic complications, mainly diabetic ophthalmopathy, diabetic cardiovascular complications and diabetic nephropathy. With diabetes complications being one of the leading causes of disability and death, the use of anti-inflammatories in combination therapy for diabetes is increasing. There has been increasing interest in targeting significant regulators of the inflammatory pathway, notably receptor-interacting serine/threonine-kinase-1 (RIPK1) and receptor-interacting serine/threonine-kinase-3 (RIPK3), as drug targets for managing inflammation in treating diabetes complications. In this review, we aim to provide an up-to-date summary of current research on the mechanism of action and drug development of RIPK1 and RIPK3, which are pivotal in chronic inflammation and immunity, in relation to diabetic complications which may be benefit for explicating the potential of selective RIPK1 and RIPK3 inhibitors as anti-inflammatory therapeutic agents for diabetic complications.
Topics: Humans; Inflammation; Diabetes Complications; Receptor-Interacting Protein Serine-Threonine Kinases; Diabetic Nephropathies; Threonine; Serine; Diabetes Mellitus
PubMed: 37954576
DOI: 10.3389/fimmu.2023.1274654 -
Graefe's Archive For Clinical and... Dec 2023Pars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle... (Review)
Review
Pars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle viewing, digitally assisted visualization, and intraoperative optical coherence tomography, contemporary PPV for diabetic retinopathy has been performed on a wider range of indications than previously considered. In this article, we reviewed, in conjunction with our collective experiences with Asian patients, the applications of new technologies for PPV in eyes with diabetic retinopathy and highlighted several important procedures and entities not generally reiterated in the literature, in order for vitreoretinal surgeons to optimize their approaches when facing the challenges imposed by the complications in diabetic eyes.
Topics: Humans; Vitrectomy; Diabetic Retinopathy; Visual Acuity; Eye; Tomography, Optical Coherence; Retinal Detachment; Diabetes Mellitus
PubMed: 37314522
DOI: 10.1007/s00417-023-06134-w -
International Journal of Molecular... Oct 2023This study investigated modifications to the ubiquitin proteasome system (UPS) in a mouse model of type 2 diabetes mellitus (T2DM) and their relationship to heart...
This study investigated modifications to the ubiquitin proteasome system (UPS) in a mouse model of type 2 diabetes mellitus (T2DM) and their relationship to heart complications. mice heart tissues were compared with mice tissues using RNA sequencing, qRT-PCR, and protein analysis to identify cardiac UPS modifications associated with diabetes. The findings unveiled a distinctive gene profile in the hearts of mice with decreased levels of mRNA and increased levels of , indicating potential cardiac dysfunction. The mRNA levels of (deubiquitinating enzyme), , and (proteasome β-subunits) were down-regulated in mice, while the mRNA levels of RNF167 (E3 ligase) were increased. Corresponding LMP2 and LMP7 proteins were down-regulated in mice, and RNF167 was elevated in diabetic mice. The reduced expression of LMP2 and LMP7, along with increased RNF167 expression, may contribute to the future cardiac deterioration commonly observed in diabetes. This study enhances our understanding of UPS imbalances in the hearts of diabetic mice and raises questions about the interplay between the UPS and other cellular processes, such as autophagy. Further exploration in this area could provide valuable insights into the mechanisms underlying diabetic heart complications and potential therapeutic targets.
Topics: Mice; Animals; Proteasome Endopeptidase Complex; Ubiquitin; Diabetes Mellitus, Type 2; Diabetes Mellitus, Experimental; Diabetic Cardiomyopathies; Diabetes Complications; RNA, Messenger
PubMed: 37895057
DOI: 10.3390/ijms242015376 -
Chest Nov 2023The prospective associations of preserved ratio impaired spirometry (PRISm) with new-onset macrovascular and microvascular complications and mortality among individuals...
BACKGROUND
The prospective associations of preserved ratio impaired spirometry (PRISm) with new-onset macrovascular and microvascular complications and mortality among individuals with type 2 diabetes (T2D) and whether PRISm enhances the prediction ability of an established office-based risk score remain to be elucidated.
RESEARCH QUESTION
Can PRISm be used as a predictor of poor prognosis in individuals with T2D?
STUDY DESIGN AND METHODS
We included 20,047 study participants with T2D and complete data on spirometry at recruitment from the UK Biobank cohort. Multivariable Cox proportional hazards models were used to assess the associations of baseline PRISm (FEV to FVC ratio, ≥ 0.70; FEV, < 80% predicted) with subsequent risks of incident stroke (any type), ischemic stroke, myocardial infarction, unstable angina, coronary heart disease, diabetic retinopathy, diabetic kidney disease, all-cause mortality, cardiovascular mortality, and respiratory mortality.
RESULTS
For this cohort analysis, 4,521 patients (22.55% of participants with T2D) showed comorbid PRISm at baseline. Over a median follow-up of 11.52 to 11.87 years, patients with T2D with PRISm at baseline showed higher risks than those with normal spirometry findings of various T2D complications developing and mortality; the adjusted hazard ratios for PRISm were 1.413 (95% CI, 1.187-1.681) for stroke (any type), 1.382 (95% CI, 1.129-1.690) for ischemic stroke, 1.253 (95% CI, 1.045-1.503) for myocardial infarction, 1.206 (95% CI, 1.086-1.339) for coronary heart disease, 1.311 (95% CI, 1.141-1.506) for diabetic retinopathy, 1.384 (95% CI, 1.190-1.610) for diabetic kidney disease, 1.337 (95% CI, 1.213-1.474) for all-cause mortality, 1.597 (95% CI, 1.296-1.967) for cardiovascular mortality, and 1.559 (95% CI, 1.189-2.044) for respiratory mortality, respectively. The addition of PRISm significantly improved the reclassification ability, based on the net reclassification index, of an office-based risk score by 15.53% (95% CI, 10.14%-19.63%) to 33.60% (95% CI, 20.90%-45.79%).
INTERPRETATION
Individuals with T2D with comorbid PRISm, accounting for a considerable proportion of the population with T2D, showed significantly increased risks of adverse macrovascular and microvascular complications and mortality.
Topics: Humans; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Diabetic Nephropathies; Spirometry; Myocardial Infarction; Stroke; Coronary Disease; Ischemic Stroke; Respiratory Tract Diseases
PubMed: 37356807
DOI: 10.1016/j.chest.2023.05.031 -
Progress in Molecular Biology and... 2024Diabetes is an ongoing global problem as it affects health of more than 537 million people around the world. Diabetes leaves many serious complications that affect... (Review)
Review
Diabetes is an ongoing global problem as it affects health of more than 537 million people around the world. Diabetes leaves many serious complications that affect patients and can cause death if not detected and treated promptly. Some of the complications of diabetes include impaired vascular system, increased risk of stroke, neurological diseases that cause pain and numbness, diseases related to the retina leading to blindness, and other complications affecting kidneys, heart failure, muscle weakness, muscle atrophy. All complications of diabetes seriously affect the health of patients. Recently, gene therapy has emerged as a viable treatment strategy for various diseases. DNA and RNA are among the target molecules that can change the structure and function of proteins and are effective methods of treating diseases, especially genetically inherited diseases. RNA therapeutics has attracted deep interest as it has been approved for application in the treatment of functional system disorders such as spinal muscular atrophy, and muscular dystrophy. In this review, we cover the types of RNA therapies considered for treatment of diabetes. In particular, we delve into the mechanism of action of RNA therapies for diabetes, and studies involving testing of these RNA therapies. Finally, we have highlighted the limitations of the current understanding in the mechanism of action of RNA therapies.
Topics: Humans; RNA; Muscular Atrophy, Spinal; Genetic Therapy; Diabetes Mellitus; Diabetes Complications
PubMed: 38360004
DOI: 10.1016/bs.pmbts.2023.12.013 -
British Journal of Community Nursing Jun 2024The escalating prevalence of diabetes mellitus presents concern due to its widespread organ damage, including the heart, kidneys, eyes, and nerves, leading to severe... (Review)
Review
The escalating prevalence of diabetes mellitus presents concern due to its widespread organ damage, including the heart, kidneys, eyes, and nerves, leading to severe complications such as heart attacks, strokes, blindness, and diabetes-related foot ulcers (DFUs). Management in the community setting should be focused on prevention, assessment and patient-centred care. By understanding the complex aetiology, risk factors, and classification of DFUs, along with utilising evidence-based interventions like the Wound, Infection and Ischemia (WIfI) system, we can streamline care. Neuropathy, peripheral arterial disease and infection are major contributors to DFU development, highlighting the importance of early detection and intervention. Comprehensive care addressing vascular health, infection control, pressure offloading, wound management, metabolic control, and patient education is essential for successful DFU management. Ultimately, proactive prevention strategies and interdisciplinary collaboration are necessary in the management of DFUs and improving patient outcomes.
Topics: Humans; Diabetic Foot; Risk Factors
PubMed: 38814845
DOI: 10.12968/bjcn.2024.29.Sup6.S30 -
African Health Sciences Sep 2023Diabetes complications are a major burden on persons living with diabetes and the health care systems.
BACKGROUND
Diabetes complications are a major burden on persons living with diabetes and the health care systems.
OBJECTIVES
The study assessed the glycemic control, prevalence and predictors of type 2 diabetes complications among patients in a healthcare centre.
METHODS
Two hundred adults who had type 2 diabetes in a general hospital were recruited for the study. Cross-sectional and retrospective surveys were used to determine prevalence, number and types of complications in the patients. SPSS version 21 was used for descriptive analysis and Chi-square (p<0.05).
RESULTS
A total of 200 (100%) respondents participated in the study and 97 (48.5%) had poor glycemic control. Mean number of complications per patient was 2.48 ± 1.22. Number of complications per person and type of complications were significantly associated with Age (p = 0.000 and p = 0.000, respectively), Gender (p = 0.008 and p = 0.031, respectively) and Occupation (p=0.000 and p=0.006, respectively). Marital status (p = 0.032) and years of diagnosis (p=0.021) were also associated with type of complications. The majority of patients 64 (32.0%) were admitted in the previous year for diabetes-related complications. Majority 159 (79.5%) had ≥ 2 number of complications from the observed 497 complications.
CONCLUSIONS
Poor glycemic control and high prevalence of complications were observed. Also, socio-demographic characteristics were likely predictors of number and type of complications. These findings are essential for improved planning and prioritizing of diabetes care.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Prevalence; Cross-Sectional Studies; Retrospective Studies; Diabetes Complications; Hyperglycemia
PubMed: 38357114
DOI: 10.4314/ahs.v23i3.37 -
Frontiers in Endocrinology 2024
Topics: Humans; Comorbidity; Diabetes Mellitus; Diabetes Complications; Diabetes Mellitus, Type 2
PubMed: 38660511
DOI: 10.3389/fendo.2024.1406131 -
Communications Biology Sep 2023The occurrence of diabetic nephropathy (DN) and diabetic retinopathy (DR) are closely associated in patients with diabetes. However, the cellular and molecular linkage...
The occurrence of diabetic nephropathy (DN) and diabetic retinopathy (DR) are closely associated in patients with diabetes. However, the cellular and molecular linkage of DN and DR has not been elucidated, and further revelations are needed to improve mutual prognostic decisions and management. Here, we generate and integrate single-cell RNA sequencing profiles of kidney and retina to explore the cellular and molecular association of kidney and retina in both physiological and pathological conditions. We find renal mesangial cells and retinal pericytes share molecular features and undergo similar molecular transitions under diabetes. Furthermore, we uncover that chemokine regulation shared by the two cell types is critical for the co-occurrence of DN and DR, and the chemokine score can be used for the prognosis of DN complicated with DR. These findings shed light on the mechanism of the co-occurrence of DN and DR and could improve the prevention and treatments of diabetic microvascular complications.
Topics: Humans; Diabetic Nephropathies; Transcriptome; Kidney; Diabetic Retinopathy; Mesangial Cells; Diabetes Mellitus
PubMed: 37670124
DOI: 10.1038/s42003-023-05300-4