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New Frontiers in Type 2 Diabetes
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New Frontiers in Type 2 Diabetes

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 14040

Special Issue Editor

Dr. Elettra Mancuso

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Interests: diabetes; cardiovascular health

Special Issue Information

Dear Colleagues,

Type 2 diabetes mellitus (T2DM) and its complications are a global epidemic and are among the most impressive demographic phenomena around the world. In the past three decades, the prevalence of T2DM has risen dramatically, and it is estimated to rise beyond half a billion cases by the end of the present decade. T2DM is a chronic, metabolic disease characterized by insulin resistance, impaired insulin secretion, and hyperglycemia. Despite adequate treatments, patients with T2DM can still suffer from numerous microvascular and macrovascular complications which cause a high burden of morbidity and mortality. Basic research and development of new therapeutic approaches used for prevention, management, and treatment of T2DM have begun unveiling the molecular and clinical complexity of this chronic disease. However, it is still necessary to investigate the progression of T2DM and its complications in order to ameliorate patient care. 

The aim of this Special Issue is to provide a collection of original research articles, comprehensive reviews, and communications, highlighting the latest frontiers in basic, translational, and clinical research. Acceptable topics include the use of new molecular technologies in diagnosis, treatment, and prognosis of T2DM and its complications. Particular interest will be given to genetic, molecular, clinical, and immune biomarkers, as well as to novel surgical tools.

Dr. Elettra Mancuso
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • T2DM
  • complication of T2DM
  • molecular mechanisms
  • molecular and genetic biomarkers
  • clinical research
  • environmental triggers and novel technologies

Published Papers (6 papers)

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Research

Jump to: Review

11 pages, 637 KiB  
Article
The Triglycerides and Glucose (TyG) Index Is Associated with 1-Hour Glucose Levels during an OGTT
by Mattia Massimino, Giuseppe Monea, Giuseppe Marinaro, Mariangela Rubino, Elettra Mancuso, Gaia Chiara Mannino and Francesco Andreozzi
Int. J. Environ. Res. Public Health 2023, 20(1), 787; https://doi.org/10.3390/ijerph20010787 - 31 Dec 2022
Cited by 6 | Viewed by 2494
Abstract
Background and Objectives: Among individuals with normal glucose tolerance (NGT), subjects with high levels of plasma glucose (≥155 mg/dL) at sixty minutes during an oral glucose tolerance test (1h-OGTT) are at an increased risk of developing type 2 diabetes. We investigated the association [...] Read more.
Background and Objectives: Among individuals with normal glucose tolerance (NGT), subjects with high levels of plasma glucose (≥155 mg/dL) at sixty minutes during an oral glucose tolerance test (1h-OGTT) are at an increased risk of developing type 2 diabetes. We investigated the association between the triglycerides and glucose (TyG) index, a novel marker of insulin resistance, with 1h-OGTT glucose plasma concentrations. Material and Methods: 1474 non-diabetic Caucasian subjects underwent a 75 g OGTT and were divided into two groups according to the cutoff 1h-OGTT plasma glucose < 155 mg/dL (NGT-1h-low) and ≥ 155 mg/dL (NGT-1h-high). The TyG index was calculated as ln [fasting triglycerides (milligrams per deciliter) × fasting blood glucose (milligrams per deciliter)/2]. Multivariable linear and logistic regression analyses were used to establish the contribution of the TyG index to the variability of 1h-OGTT glucose, and how the former affected the risk of being NGT-1h-high. Results: 1004 individuals were NGT-1h-low and 470 were NGT-1h-high. The TyG index was higher for NGT-1h-high (p = 0.001) individuals, and it was an independent factor influencing 1h-OGTT glycemia (β = 0.191, p < 0.001) after correcting for age, sex, and BMI. The TyG index was the strongest marker associated with the risk of being NGT-1h-high (OR = 1.703, CI 95% 1.34–2.17, p < 0.001) when compared with FPG (OR = 1.054, CI 95% 1.04–1.07, p < 0.001) and the HOMA-IR (OR = 1.156, CI 95% 1.08–1.23, p < 0.001). Conclusions: Our study demonstrated that the TyG index, an efficient and cost-effective marker of insulin resistance, is associated with the variability of early post-challenge glucose levels and is an independent marker of being NGT-1h-high. Full article
(This article belongs to the Special Issue New Frontiers in Type 2 Diabetes)
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17 pages, 1227 KiB  
Article
Comparing Patient Perspectives on Diabetes Management to the Deficit-Based Literature in an Ethnic Minority Population: A Mixed-Methods Study
by Kathleen Abu-Saad, Nihaya Daoud, Giora Kaplan, Arnona Ziv, Arnon D. Cohen, Liraz Olmer, Daphna Pollack and Ofra Kalter-Leibovici
Int. J. Environ. Res. Public Health 2022, 19(22), 14769; https://doi.org/10.3390/ijerph192214769 - 10 Nov 2022
Viewed by 1579
Abstract
Marginalized racial/ethnic minorities have disproportionately high rates of type 2 diabetes prevalence, complications and mortality. Researchers and policymakers have typically addressed these disparities using a deficit-based discourse focused on individual/cultural deficiencies or failure. A mixed-methods study was used to compare the deficit discourse [...] Read more.
Marginalized racial/ethnic minorities have disproportionately high rates of type 2 diabetes prevalence, complications and mortality. Researchers and policymakers have typically addressed these disparities using a deficit-based discourse focused on individual/cultural deficiencies or failure. A mixed-methods study was used to compare the deficit discourse to the perspectives of adults with diabetes in the Arab minority in Israel, using data from 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Both qualitative and quantitative data were triangulated. In addition, multivariable regression models tested associations between diabetes management perspectives and participant characteristics. Contrary to the deficit-based characterizations of patients as fatalistic and unknowledgeable, participants viewed diabetes as a chronic disease with serious complications. They expressed more support for patient responsibility in diabetes management than for passive fatalism, and were less fatalistic as educational level and adequacy of diabetes self-care training increased. The impact of social/environmental barriers and changing cultural norms on lifestyle behaviors was highlighted. Over 95% used prescription medications for diabetes management, although 35% reported economic barriers. The deficit discourse is not well-aligned with Arab patients’ evolving perceptions and needs, and has deflected attention from the socioeconomic/structural determinants of health, and the healthcare system’s responsibility to provide effective, culturally-relevant diabetes services. Full article
(This article belongs to the Special Issue New Frontiers in Type 2 Diabetes)
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12 pages, 2879 KiB  
Article
Evaluation of Impact of a Pharmacist-Led Educational Campaign on Disease Knowledge, Practices and Medication Adherence for Type-2 Diabetic Patients: A Prospective Pre- and Post-Analysis
by Yusra Habib Khan, Abdulaziz Ibrahim Alzarea, Nasser Hadal Alotaibi, Ahmed D. Alatawi, Aisha Khokhar, Abdullah Salah Alanazi, Muhammad Hammad Butt, Asrar A. Alshehri, Sameer Alshehri, Yasser Alatawi and Tauqeer Hussain Mallhi
Int. J. Environ. Res. Public Health 2022, 19(16), 10060; https://doi.org/10.3390/ijerph191610060 - 15 Aug 2022
Cited by 12 | Viewed by 2558
Abstract
Type 2 Diabetes mellitus is a major public health concern with an alarming global growth rate. According to the World Health Organization (WHO), Saudi Arabia ranks seventh in the world and second in the Middle East for the largest estimated burden of diabetic [...] Read more.
Type 2 Diabetes mellitus is a major public health concern with an alarming global growth rate. According to the World Health Organization (WHO), Saudi Arabia ranks seventh in the world and second in the Middle East for the largest estimated burden of diabetic cases. Evidence shows that pharmacist-led care programs can be beneficial for the effective treatment of diabetes mellitus. Current study was aimed to evaluate the impact of Pharmacist-Based Diabetic Intervention (PDIM) for Type 2 Diabetes patients on knowledge of the disease, adherence to medications and self-care practices during the first wave of COVID-19. A multi-arm pre-post study was conducted among type 2 diabetic patients from April to October 2021 in Sakaka, Saudi Arabia. Patients were randomly divided into an intervention and a control group. The intervention group received the PDIM, whereas the control group only received the usual care. The pharmacist-based diabetes intervention model consisted of a diabetic educational module and medication improvement strategies. Furthermore, the intervention group also received specific telepharmacy services (calls, messages or emails) to address their medication-related problems, inquire about medication adherence and follow-up. At the end of six months, disease knowledge, self-care practices, and medication adherence score were analyzed. Furthermore, HbA1c and lipid profile were also compared. A total of 109 patients were included in the study. A significant difference was observed in the knowledge score between the intervention and control group (16.89 ± 2.01 versus 15.24 ± 2.03, p-value < 0.001). Similarly, self-care practices also improved in the intervention group as compared to the control group (4.39 ± 1.10 versus 3.16 ± 0.97, p-value < 0.001). Furthermore, the medication adherence and HbA1c significantly improved during between the group analysis (p < 0.05). Our study demonstrates that pharmacist-based diabetes intervention model is effective in improving patients’ knowledge of diabetes, self-care practices, medication adherence and glycemic control. Full article
(This article belongs to the Special Issue New Frontiers in Type 2 Diabetes)
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Review

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11 pages, 560 KiB  
Review
Circadian Clock Desynchronization and Insulin Resistance
by Federica Catalano, Francesca De Vito, Velia Cassano, Teresa Vanessa Fiorentino, Angela Sciacqua and Marta Letizia Hribal
Int. J. Environ. Res. Public Health 2023, 20(1), 29; https://doi.org/10.3390/ijerph20010029 - 20 Dec 2022
Cited by 6 | Viewed by 2356
Abstract
The circadian rhythm regulates biological processes that occur within 24 h in living organisms. It plays a fundamental role in maintaining biological functions and responds to several inputs, including food intake, light/dark cycle, sleep/wake cycle, and physical activity. The circadian timing system comprises [...] Read more.
The circadian rhythm regulates biological processes that occur within 24 h in living organisms. It plays a fundamental role in maintaining biological functions and responds to several inputs, including food intake, light/dark cycle, sleep/wake cycle, and physical activity. The circadian timing system comprises a central clock located in the suprachiasmatic nucleus (SCN) and tissue-specific clocks in peripheral tissues. Several studies show that the desynchronization of central and peripheral clocks is associated with an increased incidence of insulin resistance (IR) and related diseases. In this review, we discuss the current knowledge of molecular and cellular mechanisms underlying the impact of circadian clock dysregulation on insulin action. We focus our attention on two possible mediators of this interaction: the phosphatases belonging to the pleckstrin homology leucine-rich repeat protein phosphatase family (PHLPP) family and the deacetylase Sirtuin1. We believe that literature data, herein summarized, suggest that a thorough change of life habits, with the return to synchronized food intake, physical activity, and rest, would doubtless halt the vicious cycle linking IR to dysregulated circadian rhythms. However, since such a comprehensive change may be incompatible with the demand of modern society, clarifying the pathways involved may, nonetheless, contribute to the identification of therapeutic targets that may be exploited to cure or prevent IR-related diseases. Full article
(This article belongs to the Special Issue New Frontiers in Type 2 Diabetes)
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19 pages, 1237 KiB  
Review
Pre-Existing Diabetes Mellitus, Hypertension and KidneyDisease as Risk Factors of Pre-Eclampsia: A Disease of Theories and Its Association with Genetic Polymorphism
by Abdullah Salah Alanazi, Francis Victor, Kanwal Rehman, Yusra Habib Khan, Ismaeel Yunusa, Abdulaziz Ibrahim Alzarea, Muhammad Sajid Hamid Akash and Tauqeer Hussain Mallhi
Int. J. Environ. Res. Public Health 2022, 19(24), 16690; https://doi.org/10.3390/ijerph192416690 - 12 Dec 2022
Cited by 2 | Viewed by 2871
Abstract
Pre-existing diabetes, hypertension and kidney disorders are prominent risk factors of pre-eclampsia (PE). It is a multifactorial pregnancy disorder associated with high blood pressure, proteinuria, and multiorgan failure, which develops after the 20th week of pregnancy. It is one of the most feared [...] Read more.
Pre-existing diabetes, hypertension and kidney disorders are prominent risk factors of pre-eclampsia (PE). It is a multifactorial pregnancy disorder associated with high blood pressure, proteinuria, and multiorgan failure, which develops after the 20th week of pregnancy. It is one of the most feared pregnancy disorders, as it consumes thousands of fetomaternal lives per annum. According to clinical and pathological studies, the placenta appears to be a key player in the pathogenesis of PE; however, the exact origin of this disorder is still under debate. Defective placentation and angiogenesis are the hallmarks of PE progression. This angiogenic imbalance, together with maternal susceptibility, might determine the severity and clinical presentation of PE. This article comprehensively examines the mechanisms of pathogenesis of PE and current evidence of the factors involved in its progression. Finally, this article will explore the genetic association of PE, various candidate genes, their proposed mechanisms and variants involved in its pathogenesis. Full article
(This article belongs to the Special Issue New Frontiers in Type 2 Diabetes)
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18 pages, 701 KiB  
Review
Chemical Compounds and Ambient Factors Affecting Pancreatic Alpha-Cells Mass and Function: What Evidence?
by Gaia Chiara Mannino, Elettra Mancuso, Stefano Sbrignadello, Micaela Morettini, Francesco Andreozzi and Andrea Tura
Int. J. Environ. Res. Public Health 2022, 19(24), 16489; https://doi.org/10.3390/ijerph192416489 - 8 Dec 2022
Cited by 3 | Viewed by 1445
Abstract
The exposure to different substances present in the environment can affect the ability of the human body to maintain glucose homeostasis. Some review studies summarized the current evidence about the relationships between environment and insulin resistance or beta-cell dysfunction. Instead, no reviews focused [...] Read more.
The exposure to different substances present in the environment can affect the ability of the human body to maintain glucose homeostasis. Some review studies summarized the current evidence about the relationships between environment and insulin resistance or beta-cell dysfunction. Instead, no reviews focused on the relationships between the environment and the alpha cell, although in recent years clear indications have emerged for the pivotal role of the alpha cell in glucose regulation. Thus, the aim of this review was to analyze the studies about the effects of chemical, biological, and physical environmental factors on the alpha cell. Notably, we found studies focusing on the effects of different categories of compounds, including air pollutants, compounds of known toxicity present in common objects, pharmacological agents, and compounds possibly present in food, plus studies on the effects of physical factors (mainly heat exposure). However, the overall number of relevant studies was limited, especially when compared to studies related to the environment and insulin sensitivity or beta-cell function. In our opinion, this was likely due to the underestimation of the alpha-cell role in glucose homeostasis, but since such a role has recently emerged with increasing strength, we expect several new studies about the environment and alpha-cell in the near future. Full article
(This article belongs to the Special Issue New Frontiers in Type 2 Diabetes)
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