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Biomedicine & Pharmacotherapy =... Dec 2023Ferroptosis, as a way of cell death, participates in the body's normal physiological and pathological regulation. Recent studies have shown that ferroptosis may damage... (Review)
Review
Ferroptosis, as a way of cell death, participates in the body's normal physiological and pathological regulation. Recent studies have shown that ferroptosis may damage glucose-stimulated islets β Insulin secretion and programmed cell death of T2DM target organs are involved in the pathogenesis of T2DM and its complications. Targeting suppression of ferroptosis with specific inhibitors may provide new therapeutic opportunities for previously untreated T2DM and its target organs. Current studies suggest that natural bioactive compounds, which are abundantly available in drugs, foods, and medicinal plants for the treatment of T2DM and its target organs, have recently received significant attention for their various biological activities and minimal toxicity, and that many natural compounds appear to have a significant role in the regulation of ferroptosis in T2DM and its target organs. Therefore, this review summarized the potential treatment strategies of natural compounds as ferroptosis inhibitors to treat T2DM and its complications, providing potential lead compounds and natural phytochemical molecular nuclei for future drug research and development to intervene in ferroptosis in T2DM.
Topics: Humans; Ferroptosis; Apoptosis; Cell Death; Diabetes Complications; Diabetes Mellitus, Type 2
PubMed: 37820566
DOI: 10.1016/j.biopha.2023.115544 -
Current Diabetes Reports Jul 2024Cardiovascular disease (CVD) is the leading cause of mortality in people who have diabetes. Racial and ethnic minorities with diabetes have suboptimal management of... (Review)
Review
PURPOSE OF REVIEW
Cardiovascular disease (CVD) is the leading cause of mortality in people who have diabetes. Racial and ethnic minorities with diabetes have suboptimal management of cardiovascular risk factors, leading to higher mortality. Social and structural determinants of health are external factors that influence an individual's ability to choose positive health behaviors. In this review, we will discuss cardiovascular complications in people who have diabetes and their relationship to social determinants of health (SDOH).
RECENT FINDINGS
Recent innovations in diabetes treatment, including new devices and medications, have improved care and survival. However, disparities in the availability of these treatments to racial and ethnic minorities may contribute to continued inequities in CVD outcomes. Racial/ethnic disparities in CVD relate to inequities in economic opportunity, education and health literacy, neighborhoods and social cohesion, and health care access and quality driven by structural racism.
Topics: Humans; Cardiovascular Diseases; Social Determinants of Health; Healthcare Disparities; Risk Factors; Diabetes Complications; Health Services Accessibility; Diabetes Mellitus
PubMed: 38696042
DOI: 10.1007/s11892-024-01541-7 -
International Journal of Biological... Aug 2023Diabetes mellitus causes a wide range of metabolic derangements with multiple organ damage. The microvascular and macrovascular complications of diabetes result partly... (Review)
Review
Diabetes mellitus causes a wide range of metabolic derangements with multiple organ damage. The microvascular and macrovascular complications of diabetes result partly from the damage to the glycosaminoglycans (GAG) in the basement membrane. GAGs are negatively charged polysaccharides with repeating disaccharide units. They play a significant role in cellular proliferation and signal transduction. Destruction of extracellular matrix results in diseases in various organs including myocardial fibrosis, retinal damage and nephropathy. To substitute the natural GAGs pharmacotherapeutically, they have been synthesized by using basic disaccharide units. Among the four classes of GAGs, heparin is the most widely studied. Recent studies have revealed multiple significant GAG-protein interactions suggesting their use for the management of diabetic complications. Moreover, they can act as biomarkers for assessing the disease progression. A number of GAG-based therapeutic agents are being evaluated for managing diabetic complications. The current review provides an outline of the role of GAGs in diabetes while covering their interaction with different molecular players that can serve as targets for the diagnosis, management and prevention of diabetes and its complications. The medicinal chemistry and clinical pharmacotherapeutics aspects have are covered to aid in the establishment of GAG-based therapies as a possible avenue for diabetes.
Topics: Humans; Glycosaminoglycans; Diabetes Mellitus; Diabetes Complications; Heparin; Disaccharides; Heparitin Sulfate
PubMed: 37467830
DOI: 10.1016/j.ijbiomac.2023.125821 -
Advances in Therapy Jul 2024Utility values are used in health economic modeling analyses of type 2 diabetes (T2D) to quantify the effect of acute and long-term complications on quality of life... (Review)
Review
INTRODUCTION
Utility values are used in health economic modeling analyses of type 2 diabetes (T2D) to quantify the effect of acute and long-term complications on quality of life (QoL). For accurate modeling projections, it is important that the utility values used are up to date, accurate and representative of the simulated model cohort.
METHODS
A literature review was performed to identify utility values for health states representing acute and chronic T2D-related complications including cardiovascular complications, stroke, renal disease, ophthalmic complications, neuropathy, diabetic foot, amputation and hypoglycemia. Searches were performed using the PubMed, Embase and Cochrane Library databases and limited to articles published since 2010. Supplementary searches were performed to identify data published at congresses in 2019-2023.
RESULTS
A total of 54 articles were identified that reported utility values for T2D-related complications. The most frequently used elicitation method/instrument was the EQ-5D (n = 42 studies) followed by the Short Form-6 dimensions (n = 6), time tradeoff (n = 5), the Health Utilities Index Mark 2 or Mark 3 (n = 2), 15D (n = 1), visual analog scale (n = 1) and standard gamble (n = 1). Stroke and amputation were consistently associated with the largest decrements in QoL. There is a lack of published data that distinguishes between severity of several complications including renal disease, retinopathy and neuropathy.
CONCLUSIONS
Diabetes-related complications can have a profound impact on QoL; therefore, it is important that these are captured accurately and appropriately in health economic models. Recently published utility values for diabetes-related complications that can be used to inform health economic models are summarized here.
Topics: Humans; Diabetes Mellitus, Type 2; Quality of Life; Diabetes Complications; Quality-Adjusted Life Years; Cost-Benefit Analysis; Stroke
PubMed: 38771477
DOI: 10.1007/s12325-024-02878-x -
Anatolian Journal of Cardiology Oct 2023The aim of the study was to map microvascular complications associated with diabetes mellitus from personal health records and to guide chronic disease management by...
BACKGROUND
The aim of the study was to map microvascular complications associated with diabetes mellitus from personal health records and to guide chronic disease management by revealing the economic burden of the disease.
METHOD
The data of patients with diabetes who developed microvascular complications were obtained from the e-Pulse database of the Ministry of Health, with the definitions of the disease. First, the distribution of patients by province and gender was determined and then patients with multiple complications were identified. Only direct costs and their distribution on the basis of complications were determined from the database according to the cost of illness methodology from the payer’s perspective. Then, average annual per-patient costs were determined using a top-down costing approach.
RESULTS
Between 2016 and 2020, a total of 7 656 700 patients with diabetes were reached. The number of patients with microvascular complications between 2016 and 2020 obtained from the e-Pulse database with the above definitions was 1 466 387. Regarding the complications, a total of 66 838 people developed nephropathy, 314 706 people developed retinopathy, and 1 084 843 people developed neuropathy. The total cost of patients with microvascular complications was $1 482 278 950.76 and the average annual cost per patient was $1010.84. The average annual cost of neuropathy is $659 862 971.96, retinopathy is $356 594 282.51 and nephropathy is $465 821 696.29, with per-patient costs of $701.82, $1495.24, and $10 516.11, respectively.
CONCLUSION
Diabetes mellitus, with its microvascular complications, causes significant disease and economic burden. Türkiye’s national health database system, e-Pulse, is an important database that provides patient follow-up at both individual and population levels and helps with the management of the disease and taking preventive measures before the development of the complications.
Topics: Humans; Diabetes Mellitus, Type 2; Financial Stress; Diabetes Complications; Retinal Diseases
PubMed: 37779367
DOI: 10.14744/AnatolJCardiol.2023.3762 -
Presse Medicale (Paris, France : 1983) Jun 2024Diabetic neuropathy is a frequent and severe degenerative complication of diabetes. The diagnosis is easily performed in painful symptomatic patients. Sensitivity... (Review)
Review
Diabetic neuropathy is a frequent and severe degenerative complication of diabetes. The diagnosis is easily performed in painful symptomatic patients. Sensitivity disorders responsible for numbness, tingling, and loss of feeling are part and parcel of diabetic foot syndrome and require investigation in view of preventing trophic ulcers. To date, there exists no specific treatment for diabetic neuropathy possibly preventable by careful control of metabolic disorder. Effective management of diabetic patients would make it possible to limit the dramatic consequences of diabetic neuropathy while at the same time acting on other complications.
Topics: Humans; Diabetic Neuropathies; Diabetic Foot
PubMed: 38663725
DOI: 10.1016/j.lpm.2024.104236 -
Cell Death & Disease Apr 2024Diabetes, a group of metabolic disorders, constitutes an important global health problem. Diabetes and its complications place a heavy financial strain on both patients... (Review)
Review
Diabetes, a group of metabolic disorders, constitutes an important global health problem. Diabetes and its complications place a heavy financial strain on both patients and the global healthcare establishment. The lack of effective treatments contributes to this pessimistic situation and negative outlook. Exosomes released from mesenchymal stromal cells (MSCs) have emerged as the most likely new breakthrough and advancement in treating of diabetes and diabetes-associated complication due to its capacity of intercellular communication, modulating the local microenvironment, and regulating cellular processes. In the present review, we briefly outlined the properties of MSCs-derived exosomes, provided a thorough summary of their biological functions and potential uses in diabetes and its related complications.
Topics: Humans; Exosomes; Diabetes Complications; Cell Communication; Mesenchymal Stem Cells; Treatment Outcome; Diabetes Mellitus
PubMed: 38632264
DOI: 10.1038/s41419-024-06659-w -
Clinics in Podiatric Medicine and... Apr 2024In the past 30 years, there has been a rapid influx of information pertaining to the diabetic foot (DF) coming from numerous directions and sources. This article... (Review)
Review
In the past 30 years, there has been a rapid influx of information pertaining to the diabetic foot (DF) coming from numerous directions and sources. This article discusses the current state of the DF literature and challenges it presents to clinicians with its associated increase in knowledge on their derivations, complications, and interventions. Further, we attempt to provide tips on how to navigate and criticize the current literature to encourage and maximize positive outcomes in this challenging patient population.
Topics: Humans; Diabetic Foot; Amputation, Surgical; Diabetes Mellitus
PubMed: 38388128
DOI: 10.1016/j.cpm.2023.08.003 -
Diabetes Research and Clinical Practice Jun 2024Hajj is an obligatory duty for all healthy adult Muslims once in the lifetime subjected to the ability. Considering the 10.5 % global prevalence of diabetes coupled... (Review)
Review
Hajj is an obligatory duty for all healthy adult Muslims once in the lifetime subjected to the ability. Considering the 10.5 % global prevalence of diabetes coupled with the numbers of Muslims performing the Hajj, ∼ 1.8 million in 2023, it is estimated that Muslims with diabetes performing Hajj may exceed 340,000 this year. During Hajj the pattern and amount of their meal, fluid intake and physical activity are markedly altered. Many people with diabetes insist on doing the Hajj duty, thereby creating a medical challenge for themselves and their health care providers. It is therefore important that medical professionals be aware of the potential risks that may be associated with Hajj. People with diabetes may face many health hazards during Hajj including but not limited to the killer triad which might occur during Hajj: Hypoglycemia, Foot injury and Infections. Many precautions should be taken to prevent and treat these potentially serious complications. Risk stratification, medication adjustments, proper clinical assessment, and education before doing Hajj are crucial.
Topics: Humans; Islam; Diabetes Mellitus; Diabetes Complications; Saudi Arabia; Hypoglycemia; Travel
PubMed: 38569944
DOI: 10.1016/j.diabres.2024.111647 -
Journal of Diabetes and Its... Aug 2023One of the hallmarks of health is the integrity of barriers at the cellular and tissue levels. The two cardinal functions of barriers include preventing access of... (Review)
Review
One of the hallmarks of health is the integrity of barriers at the cellular and tissue levels. The two cardinal functions of barriers include preventing access of deleterious elements of the environment (barrier function) while facilitating the transport of essential ions, signaling molecules and nutrients needed to maintain the internal milieu (transport function). There are several cellular and subcellular barriers and some of these barriers can be interrelated. The principal physiologic barriers include blood-retinal barrier, blood-brain barrier, blood-testis barrier, renal glomerular/tubular barrier, intestinal barrier, pulmonary blood-alveolar barrier, blood-placental barrier and skin barrier. Tissue specific barriers are the result of the vasculature, cellular composition of the tissue and extracellular matrix within the tissue. Uncontrolled diabetes and acute hyperglycemia may disrupt the integrity of physiologic barriers, primarily through altering the vascular integrity of the tissues and may well contribute to the clinically recognized complications of diabetes. Although diabetes is a systemic disease, some of the organs display clinically significant deterioration in function while others undergo subclinical changes. The pathophysiology of the disruption of these barriers is not entirely clear but it may be related to diabetes-related cellular stress. Understanding the mechanisms of diabetes related dysfunction of various physiologic barriers might help identifying novel therapeutic targets for reducing clinically significant complications of diabetes.
Topics: Female; Pregnancy; Male; Humans; Placenta; Blood-Brain Barrier; Blood-Retinal Barrier; Hyperglycemia; Diabetes Complications; Diabetes Mellitus
PubMed: 37356233
DOI: 10.1016/j.jdiacomp.2023.108552