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Nature Reviews. Nephrology Jul 2020Diabetes is one of the fastest growing diseases worldwide, projected to affect 693 million adults by 2045. Devastating macrovascular complications (cardiovascular... (Review)
Review
Diabetes is one of the fastest growing diseases worldwide, projected to affect 693 million adults by 2045. Devastating macrovascular complications (cardiovascular disease) and microvascular complications (such as diabetic kidney disease, diabetic retinopathy and neuropathy) lead to increased mortality, blindness, kidney failure and an overall decreased quality of life in individuals with diabetes. Clinical risk factors and glycaemic control alone cannot predict the development of vascular complications; numerous genetic studies have demonstrated a clear genetic component to both diabetes and its complications. Early research aimed at identifying genetic determinants of diabetes complications relied on familial linkage analysis suited to strong-effect loci, candidate gene studies prone to false positives, and underpowered genome-wide association studies limited by sample size. The explosion of new genomic datasets, both in terms of biobanks and aggregation of worldwide cohorts, has more than doubled the number of genetic discoveries for both diabetes and diabetes complications. We focus herein on genetic discoveries for diabetes and diabetes complications, empowered primarily through genome-wide association studies, and emphasize the gaps in research for taking genomic discovery to the next level.
Topics: Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Humans
PubMed: 32398868
DOI: 10.1038/s41581-020-0278-5 -
Bulletin of Experimental Biology and... May 2021The review presents modern views about the role of oxidative stress reactions in the pathogenesis of types 1 and 2 diabetes mellitus and their complications based on the... (Review)
Review
The review presents modern views about the role of oxidative stress reactions in the pathogenesis of types 1 and 2 diabetes mellitus and their complications based on the analysis of experimental and clinical studies. The sources of increased ROS generation in diabetes are specified, including the main pathways of altered glucose metabolism, oxidative damage to pancreatic β-cells, and endothelial dysfunction. The relationship between oxidative stress, carbonyl stress, and inflammation is described. The significance of oxidative stress reactions associated with hyperglycemia is considered in the context of the "metabolic memory" phenomenon. The results of our studies demonstrated significant ethnic and age-related variability of the LPO-antioxidant defense system parameters in patients with diabetes mellitus, which should be considered during complex therapy of the disease. Numerous studies of the effectiveness of antioxidants in diabetes mellitus of both types convincingly proved that antioxidants should be a part of the therapeutic process. Modern therapeutic strategies in the treatment of diabetes mellitus are aimed at developing new methods of personalized antioxidant therapy, including ROS sources targeting combined with new ways of antioxidant delivery.
Topics: Animals; Antioxidants; Diabetes Complications; Diabetes Mellitus; Humans; Oxidative Stress; Reactive Oxygen Species
PubMed: 34173093
DOI: 10.1007/s10517-021-05191-7 -
Cardiovascular Diabetology May 2021Several studies suggest that, together with glucose variability, the variability of other risk factors, as blood pressure, plasma lipids, heart rate, body weight, and... (Review)
Review
Several studies suggest that, together with glucose variability, the variability of other risk factors, as blood pressure, plasma lipids, heart rate, body weight, and serum uric acid, might play a role in the development of diabetes complications. Moreover, the variability of each risk factor, when contemporarily present, may have additive effects. However, the question is whether variability is causal or a marker. Evidence shows that the quality of care and the attainment of the target impact on the variability of all risk factors. On the other hand, for some of them causality may be considered. Although specific studies are still lacking, it should be useful checking the variability of a risk factor, together with its magnitude out of the normal range, in clinical practice. This can lead to an improvement of the quality of care, which, in turn, could further hesitate in an improvement of risk factors variability.
Topics: Diabetes Complications; Diabetes Mellitus; Humans; Prognosis; Risk Assessment; Risk Factors
PubMed: 33962641
DOI: 10.1186/s12933-021-01289-4 -
Advanced Science (Weinheim,... Sep 2021Type 2 diabetes is a metabolic, chronic disorder characterized by insulin resistance and elevated blood glucose levels. Although a large drug portfolio exists to keep... (Review)
Review
Type 2 diabetes is a metabolic, chronic disorder characterized by insulin resistance and elevated blood glucose levels. Although a large drug portfolio exists to keep the blood glucose levels under control, these medications are not without side effects. More importantly, once diagnosed diabetes is rarely reversible. Dysfunctions in the kidney, retina, cardiovascular system, neurons, and liver represent the common complications of diabetes, which again lack effective therapies that can reverse organ injury. Overall, the molecular mechanisms of how type 2 diabetes develops and leads to irreparable organ damage remain elusive. This review particularly focuses on novel targets that may play role in pathogenesis of type 2 diabetes. Further research on these targets may eventually pave the way to novel therapies for the treatment-or even the prevention-of type 2 diabetes along with its complications.
Topics: Diabetes Complications; Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents
PubMed: 34319011
DOI: 10.1002/advs.202100275 -
Nutrients Sep 2019This editorial aims to examine the risk factors associated with type 2 diabetes and to discuss the evidence relating to dietary strategies for managing people with this...
This editorial aims to examine the risk factors associated with type 2 diabetes and to discuss the evidence relating to dietary strategies for managing people with this condition. It is clear from the evidence presented that a range of dietary interventions can provide useful approaches for managing people with type 2 diabetes, including the regulation of blood glucose and lipid parameters, and for reducing the risks of acute and chronic diabetic complications.
Topics: Animals; Biomarkers; Blood Glucose; Diabetes Complications; Diabetes Mellitus, Type 2; Diet, Diabetic; Diet, Healthy; Energy Intake; Energy Metabolism; Humans; Lipids; Nutritional Status; Nutritive Value; Risk Factors; Treatment Outcome
PubMed: 31514301
DOI: 10.3390/nu11092177 -
Diabetologia Jan 2022International trends in traditional diabetes complications (cardiovascular, renal, peripheral vascular, ophthalmic, hepatic or neurological diseases) and mortality rates... (Review)
Review
International trends in traditional diabetes complications (cardiovascular, renal, peripheral vascular, ophthalmic, hepatic or neurological diseases) and mortality rates are poorly characterised. An earlier review of studies published up to 2015 demonstrated that most data come from a dozen high-income countries (HICs) in North America, Europe or the Asia-Pacific region and that, in these countries at least, rates of acute glycaemic fluctuations needing medical attention and amputations, myocardial infarction and mortality were all declining over the period. Here, we provide an updated review of published literature on trends in type 2 diabetes complications and mortality in adults since 2015. We also discuss issues related to data collection, analysis and reporting that have influenced global trends in type 2 diabetes and its complications. We found that most data on trends in type 2 diabetes, its complications and mortality come from a small number of HICs with comprehensive surveillance systems, though at least some low- and middle-income countries (LMICs) from Africa and Latin America are represented in this review. The published data suggest that HICs have experienced declines in cardiovascular complication rates and all-cause mortality in people with diabetes. In parallel, cardiovascular complications and mortality rates in people with diabetes have increased over time in LMICs. However, caution is warranted in interpreting trends from LMICs due to extremely sparse data or data that are not comparable across countries. We noted that approaches to case ascertainment and definitions of complications and mortality (numerators) and type 2 diabetes (the denominator) vary widely and influence the interpretation of international data. We offer four key recommendations to more rigorously document trends in rates of type 2 diabetes complications and mortality, over time and worldwide: (1) increasing investments in data collection systems; (2) standardising case definitions and approaches to ascertainment; (3) strengthening analytical capacity; and (4) developing and implementing structured guidelines for reporting of data.
Topics: Adult; Africa; Blood Glucose; Diabetes Complications; Diabetes Mellitus, Type 2; Global Health; Humans; Mortality
PubMed: 34837505
DOI: 10.1007/s00125-021-05585-2 -
Cells Oct 2021The increasing prevalence of diabetes and its complications, such as cardiovascular and kidney disease, remains a huge burden globally. Identification of biomarkers for... (Review)
Review
The increasing prevalence of diabetes and its complications, such as cardiovascular and kidney disease, remains a huge burden globally. Identification of biomarkers for the screening, diagnosis, and prognosis of diabetes and its complications and better understanding of the molecular pathways involved in the development and progression of diabetes can facilitate individualized prevention and treatment. With the advancement of analytical techniques, metabolomics can identify and quantify multiple biomarkers simultaneously in a high-throughput manner. Providing information on underlying metabolic pathways, metabolomics can further identify mechanisms of diabetes and its progression. The application of metabolomics in epidemiological studies have identified novel biomarkers for type 2 diabetes (T2D) and its complications, such as branched-chain amino acids, metabolites of phenylalanine, metabolites involved in energy metabolism, and lipid metabolism. Metabolomics have also been applied to explore the potential pathways modulated by medications. Investigating diabetes using a systems biology approach by integrating metabolomics with other omics data, such as genetics, transcriptomics, proteomics, and clinical data can present a comprehensive metabolic network and facilitate causal inference. In this regard, metabolomics can deepen the molecular understanding, help identify potential therapeutic targets, and improve the prevention and management of T2D and its complications. The current review focused on metabolomic biomarkers for kidney and cardiovascular disease in T2D identified from epidemiological studies, and will also provide a brief overview on metabolomic investigations for T2D.
Topics: Biomarkers; Diabetes Complications; Diabetes Mellitus, Type 2; Gastrointestinal Microbiome; Humans; Metabolome; Metabolomics; Systems Biology
PubMed: 34831057
DOI: 10.3390/cells10112832 -
Diabetes/metabolism Research and Reviews Feb 2022Diabetes mellitus (DM), a chronic metabolic disease characterised by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and... (Review)
Review
Diabetes mellitus (DM), a chronic metabolic disease characterised by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and prevalence of DM have been increasing over the years. The complications of DM represent a serious health problem. The long-term complications include macroangiopathy, microangiopathy and neuropathy as well as sexual dysfunction (SD) in both men and women. Erectile dysfunction (ED) has been considered the most important SD in men with DM. The prevalence of ED is approximately 3.5-fold higher in men with DM than in those without DM. Common risk factors for the development of DM and its complications include sedentary lifestyle, overweight/obesity and increased caloric consumption. Although lifestyle changes may help improve sexual function, specific treatments are often needed. This study aims to review the definition and prevalence of ED in DM, the impact of DM complications and DM treatment on ED and, finally, the current and emerging therapies for ED in patients with DM.
Topics: Blood Glucose; Diabetes Complications; Diabetes Mellitus; Diabetes Mellitus, Type 2; Erectile Dysfunction; Female; Humans; Male; Prevalence; Risk Factors
PubMed: 34514697
DOI: 10.1002/dmrr.3494 -
Frontiers in Endocrinology 2021Diabetes mellitus and the associated complications are metabolic diseases with high morbidity that result in poor quality of health and life. The lack of diagnostic... (Review)
Review
Diabetes mellitus and the associated complications are metabolic diseases with high morbidity that result in poor quality of health and life. The lack of diagnostic methods for early detection results in patients losing the best treatment opportunity. Oral hypoglycemics and exogenous insulin replenishment are currently the most common therapeutic strategies, which only yield temporary glycemic control rather than curing the disease and its complications. Exosomes are nanoparticles containing bioactive molecules reflecting individual physiological status, regulating metabolism, and repairing damaged tissues. They function as biomarkers of diabetes mellitus and diabetic complications. Considering that exosomes are bioactive molecules, can be obtained from body fluid, and have cell-type specificity, in this review, we highlight the multifold effects of exosomes in the pathology and therapy of diabetes mellitus and diabetic complications.
Topics: Animals; Biomarkers; Diabetes Complications; Diabetes Mellitus; Exosomes; Humans; Molecular Targeted Therapy
PubMed: 34764939
DOI: 10.3389/fendo.2021.756581 -
Acta Clinica Croatica Nov 2022The course of diabetes is marked by the development of chronic complications that, in addition to affecting health, also affect the quality of life of patients. The... (Review)
Review
The course of diabetes is marked by the development of chronic complications that, in addition to affecting health, also affect the quality of life of patients. The purpose of this study was to compare the quality of life of patients with type 2 diabetes based on their chronic complications. The study, which was conducted from March 2019 until March 2020, included 382 diabetic patients, specific data from medical records, and the application of the World Health Organization Quality of Life-Brief questionnaire. There were more men than women included in the study, with the majority of respondents belonging to the age group of 61 to 70 years. In the quality-of-life assessment, the mean value of physical functioning was 57.14 (42.86-71.43), psychological functioning was 66.67 (54.17-79.17), social functioning 66.67 (50.00-75.00), and environmental functioning was 68.75 (50.00-75.00). The domains of social functioning were lowest in patients with diabetic retinopathy and neuropathy, while the physical functioning domains were rated lowest in patients with diabetic nephropathy, diabetic foot ulcer, and multiple chronic complications. All domains were rated lowest by patients with multiple complications and highest by those without any complications. In conclusion, differences in the assessment of quality of life of diabetic patients depend on the type of chronic complication.
Topics: Male; Humans; Female; Middle Aged; Aged; Diabetes Mellitus, Type 2; Quality of Life; Diabetic Foot; Diabetic Nephropathies; Diabetic Retinopathy; Diabetes Complications
PubMed: 37492372
DOI: 10.20471/acc.2022.61.03.18