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Biomedicines
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Diabetes: Comorbidities, Therapeutics and Insights (2nd Edition)
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Diabetes: Comorbidities, Therapeutics and Insights (2nd Edition)

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 2000

Special Issue Editor

Dr. Tomislav Bulum

E-Mail Website
Guest Editor
1. Vuk Vrhovac Univerity Clinic, Merkur University Hospital, Zajčeva 19, 10000 Zagreb, Croatia
2. Medical Faculty, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
Interests: diabetes type 1; diabetes type 2; metabolic syndrome; diabetic nephropathy; diabetic retinopathy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetes is one of the most challenging health problems of the 21st century, being projected to affect 700 million people by 2045. In the last 15 years, the number of people diagnosed with type 1 diabetes increased by 45%, and those diagnosed with type 2 diabetes increased by 95%. The most devastating effects of diabetes are its chronic complications, which confer a high risk of morbidity and mortality and an increased health system cost burden. Although there is increased awareness and new therapeutic options in the treatment of diabetes, it is still the leading cause of blindness in working-age adults, the leading cause of kidney failure and dialysis, and the leading cause of nontraumatic lower-limb amputations. People with diabetes have a two to four times higher risk of developing cardiovascular disease, which remains the most common cause of death in people with diabetes. Diabetes is a very heterogenous and complex disease and in addition to the traditional risk factors, such as hyperglycemia, hypertension, and dyslipidemia, multiple cellular pathways and potential molecular mechanisms are also implicated in diabetes-induced complications.

Considering this context, we welcome submissions to this Special Issue focusing on diabetes comorbidities, therapeutics, and insights into this disease. Detailed knowledge of this harmful disease is needed to prevent chronic complications and cardiovascular disease/death and optimize quality of life.

Dr. Tomislav Bulum
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. Biomedicines 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 2600 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

  • diabetes
  • complications
  • diabetic retinopathy
  • diabetic neuropathy
  • diabetic nephropathy
  • biomarkers

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Related Special Issue

Published Papers (4 papers)

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Research

12 pages, 828 KiB  
Article
Artificial Intelligence Algorithm to Screen for Diabetic Neuropathy: A Pilot Study
by Giovanni Sartore, Eugenio Ragazzi, Francesco Pegoraro, Mario German Pagno, Annunziata Lapolla and Francesco Piarulli
Biomedicines 2025, 13(5), 1075; https://doi.org/10.3390/biomedicines13051075 - 29 Apr 2025
Abstract
Background/Objectives: Patients with type 2 diabetes (T2D) are at risk of developing multiple complications, and diabetic polyneuropathy (DPN) is by far the most common. The purpose of the present study was to assess the ability of a new algorithm based on artificial [...] Read more.
Background/Objectives: Patients with type 2 diabetes (T2D) are at risk of developing multiple complications, and diabetic polyneuropathy (DPN) is by far the most common. The purpose of the present study was to assess the ability of a new algorithm based on artificial intelligence (AI) to identify patients with T2D who are at risk of DPN in order to move on to further instrumental evaluation with the biothesiometer method. Methods: This is a single-centre, cross-sectional study with 201 consecutive T2D patients recruited at the Diabetes Operating Unit of the ULSS 6 of Padua (Northeast Italy). The individual risk of developing DPN was calculated using the AI-based MetaClinic Prediction Algorithm and compared with the DPN diagnosis provided by the digital biothesiometer method, which measures the vibratory perception threshold (VPT) on both feet. Results: Of the enrolled patients, 107 (53.23%) were classified by AI software as having a low probability of developing DPN, 39 (19.40%) as having a moderate probability, 29 (14.43%) as having a high probability, and 26 (12.94%) as having a very high probability. In 63 of the total patients, biothesiometer measurement showed a VPT ≥ 25 V, indicative of DPN, while 138 patients had a non-pathological VPT value (< 25 V) (prevalence of abnormal VPT 31.34%; prevalence of normal VPT 68.66%). The overall agreement between biothesiometer results and AI risk attribution was 65%. Cohen’s κ was 0.162, and Gwet’s AC1 coefficient 0.405. Conclusions: The use of an optimized AI algorithm can help estimate the risk of developing DPN, thereby guiding more targeted and in-depth screening, including instrumental assessment using the biothesiometer method. Full article
(This article belongs to the Special Issue Diabetes: Comorbidities, Therapeutics and Insights (2nd Edition))
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18 pages, 2759 KiB  
Article
The Risk of Vestibular Disorders with Semaglutide and Tirzepatide: Findings from a Large Real-World Cohort
by Eman A. Toraih, Awwad Alenezy, Mohammad H. Hussein, Shahmeer Hashmat, Saitej Mummadi, Nawaf Farhan Alrawili, Ahmed Abdelmaksoud and Manal S. Fawzy
Biomedicines 2025, 13(5), 1049; https://doi.org/10.3390/biomedicines13051049 - 26 Apr 2025
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Abstract
Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the treatment of type 2 diabetes and obesity. While their metabolic benefits are well-established, their potential effects on vestibular function remain unexplored. This study investigated the association between GLP-1RA use and the risk of [...] Read more.
Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the treatment of type 2 diabetes and obesity. While their metabolic benefits are well-established, their potential effects on vestibular function remain unexplored. This study investigated the association between GLP-1RA use and the risk of vestibular disorders. Methods: Using the TriNetX research network (accessed 3 November 2024), we conducted a retrospective cohort study of adults prescribed semaglutide (n = 419,497) or tirzepatide (n = 77,259) between January 2018 and October 2024. Cases were matched 1:1 with controls using propensity scores based on demographics and comorbidities. The primary outcome was new-onset vestibular disorders, analyzed at 6 months, 1 year, and 3 years after treatment initiation. Results: Both medications were associated with an increased risk of vestibular disorders. Semaglutide users showed a higher cumulative incidence (0.12% at 6 months to 0.41% at 3 years) compared to controls (0.03% to 0.16%, p < 0.001), with hazard ratios ranging from 4.02 (95% CI: 3.33–4.86) at 6 months to 4.95 (95% CI: 4.51–5.43) at 3 years. Tirzepatide users demonstrated similar patterns but lower absolute rates (0.10% at 6 months to 0.19% at 3 years vs. controls 0.04% to 0.15%), with hazard ratios from 3.19 (95% CI: 2.11–4.81) to 4.55 (95% CI: 3.43–6.03). The direct comparison showed a higher risk with semaglutide versus tirzepatide (RR 1.53–2.04, p < 0.001). Conclusions: GLP-1RA therapy is associated with an increased risk of vestibular disorders, with a higher risk observed with semaglutide compared to tirzepatide. These findings suggest the need for vestibular symptom monitoring in patients receiving these medications and warrant further investigation into underlying mechanisms. Full article
(This article belongs to the Special Issue Diabetes: Comorbidities, Therapeutics and Insights (2nd Edition))
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28 pages, 3440 KiB  
Article
Multilevel Assessment of Glycemic, Hormonal, and Oxidative Parameters in an Experimental Diabetic Female Rat Model
by Iulian Tătaru, Ioannis Gardikiotis, Oana-Maria Dragostin, Luminita Confederat, Cerasela Gîrd, Alexandra-Simona Zamfir, Ionela Daniela Morariu, Carmen Lidia Chiţescu, Ancuța Dinu (Iacob), Liliana Costea Popescu and Carmen Lăcrămioara Zamfir
Biomedicines 2025, 13(4), 922; https://doi.org/10.3390/biomedicines13040922 - 9 Apr 2025
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Abstract
Background: Diabetes mellitus induces profound metabolic and endocrine alterations, impacting reproductive function through oxidative stress and hormonal imbalances. This study investigated the effects of alloxan-induced diabetes on hormonal status and oxidative stress in female Wistar rats. Methods: A synthetic sulfonamide derivative [...] Read more.
Background: Diabetes mellitus induces profound metabolic and endocrine alterations, impacting reproductive function through oxidative stress and hormonal imbalances. This study investigated the effects of alloxan-induced diabetes on hormonal status and oxidative stress in female Wistar rats. Methods: A synthetic sulfonamide derivative (compound S) was obtained via chemical synthesis and characterized by elemental and spectral analysis. Salvia officinalis extract was phytochemically profiled using UHPLC-HRMS and assessed for antioxidant potential using DPPH, ABTS, and FRAP assays. The synthetic compound and the plant extract, along with metformin were evaluated in vivo for their potential antihyperglycemic, hormone-regulating, and antioxidant properties., Serum levels of progesterone, estradiol, and follicle-stimulating hormone (FSH) were evaluated alongside oxidative stress biomarkers transforming growth factor-beta 1 (TGF-β1) and glutathione peroxidase 3 (GPX3). Results: Diabetic rats (untreated) exhibited a significant decrease in estradiol (22.00 ± 4.1 pg/mL vs. 54.74 ± 17.5 pg/mL in controls, p < 0.001) and an increase in progesterone levels (17.38 ± 9.6 ng/mL vs. 3.59 ± 0.90 ng/mL in controls, p < 0.05), suggestive for ovarian dysfunction. TGF-β1 levels were elevated in diabetic rats (27.73 ± 19.4 ng/mL vs. 21.55 ± 13.15 ng/mL in controls, p < 0.05), while increased serum GPX3 (61.50 ± 11.3 ng/mL vs. 38.20 ± 12.84 ng/mL in controls, p < 0.05) indicates enhanced oxidative stress. Statistical analysis revealed a correlation between serum GPX3 levels, FSH (p = −0.039), and estradiol (p = −0.025) in the diabetic group (L2). Conclusions: These findings contribute new evidence regarding the effects of diabetes on reproductive hormones and oxidative stress in female models. Full article
(This article belongs to the Special Issue Diabetes: Comorbidities, Therapeutics and Insights (2nd Edition))
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12 pages, 249 KiB  
Article
Association Between Hypertension, Dipping Status, and ACE and AGTR1 Gene Polymorphisms in Adolescents with Type 1 Diabetes
by Smiljka Kovacevic, Maja Jesic, Vera Zdravkovic, Stefan Djordjevic, Jelena Miolski, Vladimir Gasic, Marina Jelovac, Milena Ugrin, Sonja Pavlovic and Branko Subosic
Biomedicines 2025, 13(3), 615; https://doi.org/10.3390/biomedicines13030615 - 3 Mar 2025
Viewed by 567
Abstract
Objectives: This study aims to show the distribution of angiotensin-converting enzyme (ACE) rs1799752 (I>D) gene insertion/deletion (I/D) polymorphism and angiotensin II receptor type 1 (AGTR1) rs5186 (A>C) gene polymorphism in adolescents with hypertension (HT) and type [...] Read more.
Objectives: This study aims to show the distribution of angiotensin-converting enzyme (ACE) rs1799752 (I>D) gene insertion/deletion (I/D) polymorphism and angiotensin II receptor type 1 (AGTR1) rs5186 (A>C) gene polymorphism in adolescents with hypertension (HT) and type 1 diabetes (T1D), as well as its association with hypertension and the diurnal variation of mean blood pressure (dipping phenomenon). Methods: A cross-sectional study was conducted involving 118 adolescents diagnosed with T1D who underwent clinical and laboratory investigations, genetic analyses, and 24 h ambulatory blood pressure monitoring. The genotype frequencies were compared between adolescents with HT and those with normal blood pressure. Additionally, the genotype frequencies were compared between dippers and non-dippers. Results: Patients with HT were more likely to be female and exhibited significantly poorer glycemic control and higher triglycerides, along with increased body mass index and daily insulin dosage. The prevalence of ACE rs1799752 genotypes in the hypertensive group was 20% II, 66.7% ID, and 13.3% DD, which did not significantly differ from the normal blood pressure group with 29.1% II, 53.4% ID, and 17.5% DD (p = 0.625). The prevalence of AGTR1 rs5186 genotypes in the hypertensive group was 53.3% AC, 40% AA, and 6.7% CC, which also did not significantly differ from the normal blood pressure group with 39.8% AC, 52.4% AA, and 7.8% CC (p = 0.608). A total of 46% of the patients exhibited non-dipping phenomena. The prevalence of non-dippers among the ACE genotypes was 13% DD, 33.3% II, and 53.7% ID (p = 0.369), while for the AGTR1 genotypes, it was 50% AA, 42.6% AC, and 7.4% CC (p = 0.976). Conclusions: Our results indicate that in our adolescents with T1D, clinical and metabolic factors such as higher body mass index, triglycerides, suboptimal glycemic control, and female gender are more indicative of the development of hypertension than ACE and AGTR1 gene polymorphisms. A potential reason for this finding could be the young age of the patients or the relatively small size of the study group. Future research involving larger sample sizes is needed to further investigate the genetic predisposition for the development of hypertension. Full article
(This article belongs to the Special Issue Diabetes: Comorbidities, Therapeutics and Insights (2nd Edition))
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