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International Journal of Molecular... May 2020Nonalcoholic fatty liver disease (NAFLD) consists of the entire spectrum of fatty liver disease in patients without significant alcohol consumption, ranging from... (Review)
Review
Nonalcoholic fatty liver disease (NAFLD) consists of the entire spectrum of fatty liver disease in patients without significant alcohol consumption, ranging from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) to cirrhosis, with NASH recently shown as an important cause of hepatocellular carcinoma (HCC). There is a close relationship between insulin resistance (IR) and NAFLD, with a five-fold higher prevalence of NAFLD in patients with type 2 diabetes (T2DM) compared to that in patients without T2DM. IR is involved in the progression of disease conditions such as steatosis and NASH, as well as hepatic fibrosis progression. The mechanisms underlying these processes involve genetic factors, hepatic fat accumulation, alterations in energy metabolism, and inflammatory signals derived from various cell types including immune cells. In NASH-associated fibrosis, the principal cell type responsible for extracellular matrix production is the hepatic stellate cell (HSC). HSC activation by IR involves "direct" and "indirect" pathways. This review will describe the molecular mechanisms of inflammation and hepatic fibrosis in IR, the relationship between T2DM and hepatic fibrosis, and the relationship between T2DM and HCC in patients with NAFLD.
Topics: Animals; Diabetes Mellitus; Humans; Insulin Resistance; Non-alcoholic Fatty Liver Disease
PubMed: 32485838
DOI: 10.3390/ijms21113863 -
Cardiovascular Diabetology Apr 2023Among the complications of diabetes, cardiovascular events and cardiac insufficiency are considered two of the most important causes of death. Experimental and clinical... (Review)
Review
Among the complications of diabetes, cardiovascular events and cardiac insufficiency are considered two of the most important causes of death. Experimental and clinical evidence supports the effectiveness of SGLT2i for improving cardiac dysfunction. SGLT2i treatment benefits metabolism, microcirculation, mitochondrial function, fibrosis, oxidative stress, endoplasmic reticulum stress, programmed cell death, autophagy, and the intestinal flora, which are involved in diabetic cardiomyopathy. This review summarizes the current knowledge of the mechanisms of SGLT2i for the treatment of diabetic cardiomyopathy.
Topics: Humans; Sodium-Glucose Transporter 2 Inhibitors; Diabetic Cardiomyopathies; Heart Failure; Diabetes Mellitus, Type 2
PubMed: 37055837
DOI: 10.1186/s12933-023-01816-5 -
Diabetologia Sep 2020The convergence of advances in medical science, human biology, data science and technology has enabled the generation of new insights into the phenotype known as...
The convergence of advances in medical science, human biology, data science and technology has enabled the generation of new insights into the phenotype known as 'diabetes'. Increased knowledge of this condition has emerged from populations around the world, illuminating the differences in how diabetes presents, its variable prevalence and how best practice in treatment varies between populations. In parallel, focus has been placed on the development of tools for the application of precision medicine to numerous conditions. This Consensus Report presents the American Diabetes Association (ADA) Precision Medicine in Diabetes Initiative in partnership with the European Association for the Study of Diabetes (EASD), including its mission, the current state of the field and prospects for the future. Expert opinions are presented on areas of precision diagnostics and precision therapeutics (including prevention and treatment) and key barriers to and opportunities for implementation of precision diabetes medicine, with better care and outcomes around the globe, are highlighted. Cases where precision diagnosis is already feasible and effective (i.e. monogenic forms of diabetes) are presented, while the major hurdles to the global implementation of precision diagnosis of complex forms of diabetes are discussed. The situation is similar for precision therapeutics, in which the appropriate therapy will often change over time owing to the manner in which diabetes evolves within individual patients. This Consensus Report describes a foundation for precision diabetes medicine, while highlighting what remains to be done to realise its potential. This, combined with a subsequent, detailed evidence-based review (due 2022), will provide a roadmap for precision medicine in diabetes that helps improve the quality of life for all those with diabetes.
Topics: Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetes, Gestational; Europe; Female; Health Equity; Humans; Mental Health; Patient-Centered Care; Precision Medicine; Pregnancy; Quality of Life; Societies, Medical; United States
PubMed: 32556613
DOI: 10.1007/s00125-020-05181-w -
Frontiers in Endocrinology 2022
Topics: Humans; Diabetes Mellitus
PubMed: 36465623
DOI: 10.3389/fendo.2022.1091358 -
Acta Medica Portuguesa Dec 2021
Topics: Diabetes Complications; Diabetes Mellitus; Diabetes Mellitus, Type 2; Humans
PubMed: 32456770
DOI: 10.20344/amp.13111 -
Clinical Medicine (London, England) Sep 2019Post-transplant diabetes mellitus (PTDM) is common following solid organ transplantation, and is a risk factor for graft failure and patient mortality. In addition to... (Review)
Review
Post-transplant diabetes mellitus (PTDM) is common following solid organ transplantation, and is a risk factor for graft failure and patient mortality. In addition to standard diabetes risk factors such as obesity and ethnicity, patients undergoing transplantation also have the additional risk factors of immunosuppressive agents and infections such as hepatitis C. Patients undergoing transplant assessment should be screened for diabetes. If non-diabetic, but deemed at high risk, they should be offered careful lifestyle advice to reduce risk of post-transplant weight gain and therefore reduce risk of PTDM. Hyperglycaemia in the early post-operative period should be managed ideally with insulin therapy. Once clinically stable, there may be an opportunity to reduce or stop insulin, and consider oral hypoglycaemic agents. Despite lack of evidence from randomised trials, PTDM should be actively screened for in all transplant recipients, and actively managed with structured education, screening for complications, cardiovascular risk reduction and anti-hyperglycaemic therapy.
Topics: Diabetes Mellitus; Humans; Hyperglycemia; Organ Transplantation; Postoperative Complications; Risk Factors
PubMed: 31530687
DOI: 10.7861/clinmed.2019-0195 -
Frontiers in Endocrinology 2022
Topics: COVID-19; Diabetes Mellitus; Humans; Hypoglycemic Agents; Metformin
PubMed: 35769073
DOI: 10.3389/fendo.2022.933562 -
Journal of Religion and Health Jun 2022Four key themes are explored in this third issue of the Journal of Religion and Health for 2022: (1) the lead topic for this issue considers the work and spiritual care...
Four key themes are explored in this third issue of the Journal of Religion and Health for 2022: (1) the lead topic for this issue considers the work and spiritual care provided by nurses, which is followed by a series of articles on the subject areas of (2) diabetes and (3) hemodialysis. Then, like previous issues, we again consider (4) research exploring the effects of COVID-19. Finally, this issue presents a miscellaneous collection of articles with respect to various faith dynamics and the findings from several national surveys.
Topics: COVID-19; Diabetes Mellitus; Humans; Religion; Renal Dialysis; Spirituality
PubMed: 35581486
DOI: 10.1007/s10943-022-01586-6 -
Diabetes & Metabolism Journal Jul 2021Diabetic peripheral neuropathy (DPN) is one of the most serious complications of type 2 diabetes mellitus (T2DM). DPN increases the risk of ulcers, foot infections, and...
BACKGROUND
Diabetic peripheral neuropathy (DPN) is one of the most serious complications of type 2 diabetes mellitus (T2DM). DPN increases the risk of ulcers, foot infections, and noninvasive amputations, ultimately leading to long-term disability.
METHODS
Seven hundred patients with T2DM were investigated from 2013 to 2017 in the Sanlin community by obtaining basic data from the electronic medical record system (EMRS). From September 2018 to July 2019, 681 patients (19 missing) were investigated using a questionnaire, physical examination, biochemical index test, and follow-up Toronto clinical scoring system (TCSS) test. Patients with a TCSS score ≥6 points were diagnosed with DPN. After removing missing values, 612 patients were divided into groups in a 3:1 ratio for external validation. Using different Lasso analyses (misclassification error, mean squared error, -2log-likelihood, and area under curve) and a logistic regression analysis of the training set, models A, B, C, and D were established. The receiver operating characteristic (ROC) curve, calibration plot, dynamic component analysis (DCA) measurements, net classification improvement (NRI) and integrated discrimination improvement (IDI) were used to validate discrimination and clinical practicality of the model.
RESULTS
Through data analysis, model A (containing four factors), model B (containing five factors), model C (containing seven factors), and model D (containing seven factors) were built. After calibration, ROC curve, DCA, NRI and IDI, models C and D exhibited better accuracy and greater predictive power.
CONCLUSION
Four prediction models were established to assist with the early screening of DPN in patients with T2DM. The influencing factors in model C and D are more important factors for patients with T2DM diagnosed with DPN.
Topics: Diabetes Mellitus, Type 2; Diabetic Neuropathies; Humans; ROC Curve; Risk Factors
PubMed: 34352988
DOI: 10.4093/dmj.2020.0100 -
Journal of Diabetes and Its... Oct 2022Urologic complications such as bladder and sexual dysfunction among men and women with diabetes have received relatively little attention. This is despite emerging... (Review)
Review
Urologic complications such as bladder and sexual dysfunction among men and women with diabetes have received relatively little attention. This is despite emerging evidence that demonstrates that urologic complications increase with age in the general population and are more common in individuals with diabetes compared to those without diabetes. Here we summarize the latest information about the epidemiology of urologic complications in the setting of diabetes and the most recent findings regarding pathophysiology. In addition, we identify knowledge gaps and need for future funding to address these gaps that will reduce the burden of urologic complications in diabetes and optimize quality of life for all individuals affected by it.
Topics: Diabetes Complications; Diabetes Mellitus; Female; Humans; Male; Quality of Life; Sexual Dysfunction, Physiological
PubMed: 36088680
DOI: 10.1016/j.jdiacomp.2022.108288