Therapeutic Strategies for Diabetic Kidney Disease
Disrupted Self-Management and Adaption to New Diabetes Routines: A Qualitative Study of How People with Diabetes Managed Their Illness during the COVID-19 Lockdown
Another Player in the Field: Involvement of Glycotoxins and Glycosative Stress in Insulin Secretion and Resistance

Journal Description

Diabetology

Diabetology is an international, scientific, peer-reviewed, open access journal of diabetes research and is published quarterly online by MDPI.

Open Access—free to download, share, and reuse content. Authors receive recognition for their contribution when the paper is reused.
Rapid Publication: First decisions in 15 days; acceptance to publication in 3 days (median values for MDPI journals in the second half of 2020).
Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.

Imprint Information Journal Flyer Open Access ISSN: 2673-4540

Latest Articles

Open AccessArticle

The Potential Role of Polyelectrolyte Complex Nanoparticles Based on Cashew Gum, Tripolyphosphate and Chitosan for the Loading of Insulin

Janira M. N. A. Bezerra

Antônia C. J. Oliveira

Mônica F. La R. Soares

and

José L. Soares-Sobrinho

Diabetology 2021, 2(2), 107-116; https://doi.org/10.3390/diabetology2020009 - 08 Jun 2021

Abstract

Polyelectrolytic complexation has stood out due to its application in the development of drug delivery systems using biopolymers as raw materials. The formation of complexes between cashew gum and chitosan can be intermediated by cross-links, mediated by the action of the sodium tripolyphosphate crosslinking agent. These polymers have been used in the nanotechnological development of formulations to protect peptide drugs, such as insulin, allowing their oral administration. In this work, we describe the development of polyelectrolytic complexes from cashew gum and chitosan as biopolymers for oral administration of insulin. The obtained complexes showed a mean particle size of 234 nm and polydispersity index of 0.2. The complexes were 234 nm in size, PDI 0.2, zeta potential −4.5 mV and 22% trapping. The obtained complexes demonstrated considerable and promising characteristics for use as oral insulin delivery systems. Full article

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Open AccessFeature PaperArticle

Dietary Imbalance between Natural and Added Nutrient Sources Is Associated with Higher Fat Mass in Young Non-Obese Individuals

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Diabetology 2021, 2(2), 95-106; https://doi.org/10.3390/diabetology2020008 - 20 May 2021

Abstract

Increased energy intake from carbohydrates and sugars has been associated with overweight and obesity, risk factors for type 2 diabetes. However, such an association is higher with westernised diets with higher amounts of processed foods. Our aim was to correlate the dietary intake of sugars and lipids from naturally present and added sources with fat mass in young individuals. We performed an observational study in 80 young non-obese individuals, who completed food frequency and nutritional knowledge (NK) questionnaires, as well as an anthropometric evaluation. Foods were divided into naturally or added sources of sugars and lipids, and the intake from both sources was calculated separately. Individuals with a higher fat mass percentage had lower NK and lower consumption of lipids and sugars from naturally present sources. Moreover, consumption of lipids and sugars from naturally present sources was negatively correlated with nutritional knowledge and anthropometric markers of overweight, especially body weight and waist circumference. In non-obese young adults, lower consumption of sugars and lipids from naturally present sources instead of added ones is higher in individuals with excessive fat mass percentage and correlated with anthropometric markers of fat mass. Such dietary imbalance is associated with lower nutritional knowledge, suggesting that it could be a strategy to strengthen the prevention of obesity and associated pathologies later in life. Full article

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Open AccessFeature PaperReview

Quinoa’s Potential to Enhance Dietary Management of Obesity and Type-2 Diabetes: A Review of the Current Evidence

Alexander Little

Kevin Murphy

and

Patrick Solverson

Diabetology 2021, 2(2), 77-94; https://doi.org/10.3390/diabetology2020007 - 13 May 2021

Abstract

The prevalence of diet-induced obesity and type-2 diabetes remains a growing concern in the United States. As best management practices still include improved diet and physical activity, bioactive food components, contained within functional foods, show promise in curbing the cardiometabolic complications associated with excess weight and diabetes. Quinoa is an emerging candidate crop for its versatility in wide-ranging growing conditions as one approach to address food security, but it also contains several components that may serve as a dietary tool for post-industrial countries struggling with the health complications of caloric excess. Preliminary rodent feeding studies demonstrate that components within quinoa, namely, phytosteroids, phenolics, polysaccharides, and peptides, can prevent adiposity, dyslipidemia, and hyperglycemia. Mechanistic activity may involve reduced lipid absorption and adipogenesis, increased energy expenditure and glucose oxidation and corrected gut microbiota. Other intestinal actions may include blocked carbohydrate digestion with enhanced incretin signaling. Evidence in clinical trials is lacking and future research spanning cells to the clinic is needed to further elucidate the interesting preliminary reports reviewed here. Quinoa offers several unique attributes that could be harnessed to improve the dietary management of obesity and diabetes. Full article

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Open AccessArticle

Identifying User Requirements for an Integrated E-Health Unit for Diabetes Mellitus

Maria Tzilini

Dimitris Folinas

and

Kyriakos Kazakos

Diabetology 2021, 2(2), 65-76; https://doi.org/10.3390/diabetology2020006 - 02 May 2021

Abstract

“Continuity of Care” is the main prerequisite for the unhindered movement of people across borders within the European Union (EU). The COntinuity of care in MEtabolic diseases through modern TECHnology (COMETECH) project aims to address the problem of inadequate access to health system services to people who live in isolated communities in Greece and North Macedonia cross-border areas. As the project is almost completed, 4 e-health units—2 in each country—have been established in isolated and deprived communities, aiming at introducing “Continuity of Care” for patients with diabetes in the border region between those countries. The establishment of the e-health units allows affordable access to medical services within Greece-North Macedonia cross-border area. These units (equipped with state-of-the-art medical devices, supported by an advanced software application and medical staff) record data of local people and offer valuable and high-quality medical care services. The records of the EU citizens using the COMETECH services are safely and easily accessible by their physicians. This paper presents the user requirements of e-health units and the medical devices that are set up for the COMETECH Project for helping people with diabetes in the targeted countries. Full article

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Open AccessFeature PaperReview

First, Do No Harm: Critical Appraisal of Protein Restriction for Diabetic Kidney Disease

Satoru Yamada

Diabetology 2021, 2(2), 51-64; https://doi.org/10.3390/diabetology2020005 - 22 Apr 2021

Abstract

Low-protein diets have been recommended as diet therapy for the management of chronic kidney disease; however, its effect on chronic kidney disease has not been scientifically proven. Although several studies have reported significantly more favorable results with low-protein diet than with normal-protein diet, the renal protective effects of low-protein diets are still unclear in diabetic patients with chronic kidney disease. Moreover, some studies have reported that extremely low-protein diets may increase the risk of mortality. Thus, this paper describes the effectiveness and safety of low-protein diets for patients with diabetic kidney disease by reviewing the historical background of different low-protein diets that were critically examined in several studies. Full article

(This article belongs to the Special Issue Therapeutic Strategies for Diabetic Kidney Disease)

Open AccessReview

Diabetes Mellitus: Insights from Epidemiology, Biochemistry, Risk Factors, Diagnosis, Complications and Comprehensive Management

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Diabetology 2021, 2(2), 36-50; https://doi.org/10.3390/diabetology2020004 - 16 Apr 2021

Abstract

Diabetes mellitus has become a serious and chronic metabolic disorder that results from a complex interaction of genetic and environmental factors, principally characterized by hyperglycemia, polyuria, and polyphagia. Uncontrolled high blood sugar can result in a host of diabetic complications. Prolonged diabetes leads to serious complications some of which are life-threatening. The prevalence of diabetes patients is rising at epidemic proportions throughout the world. Every year, a major portion of the annual health budget is spent on diabetes and related illnesses. Multiple risk factors are involved in the etiopathogenesis of the disease and turning the disease into an epidemic. Diabetes, for which there is no cure, apparently can be kept under control by maintaining self-care in daily living, effective diabetes education, with comprehensive improvements in knowledge, attitudes, skills, and management. In this review, we focused on the biochemical aspects of diabetes, risk factors including both environmental and genetic, disease complications, diagnosis, management, and currently available medications for the treatment of diabetes. Full article

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Open AccessCommentary

Therapeutic Strategies for Diabetic Kidney Disease

Keiichiro Matoba

Diabetology 2021, 2(1), 31-35; https://doi.org/10.3390/diabetology2010003 - 12 Mar 2021

Abstract

Diabetic kidney disease (DKD) is a global epidemic leading to end-stage renal disease (ESRD) and susceptibility to cardiovascular disease, with few therapeutic interventions. A hallmark of DKD is the activation of the renin-angiotensin-aldosterone system and hemodynamic changes in glomerulus. Although intensive therapy with agents that targets those abnormalities lowers the risk of DKD progression, it does not completely abolish the risk of ESRD and cardiovascular events. Recent studies have illustrated the importance of renal inflammation, oxidative stress, and activated Rho-associated protein kinase (ROCK) signaling as essential pathogenesis for the development of DKD. In this commentary, these topics will be discussed. Full article

Open AccessFeature PaperArticle

Diabetes Awareness, Treatment, and Control among Mexico City Residents

Simón Barquera

César Hernández-Alcaraz

Alejandra Jáuregui

Catalina Medina

Kenny Mendoza-Herrera

Andrea Pedroza-Tobias

Lizbeth Tolentino Mayo

Luz Elizabeth Guillen Pineda

Ruy López-Ridaura

and

Carlos A. Aguilar Salinas

Diabetology 2021, 2(1), 16-30; https://doi.org/10.3390/diabetology2010002 - 18 Feb 2021

Abstract

Early diagnosis and control of diabetes can reduce premature mortality and disability. We described the diabetes prevalence, awareness, treatment, and control in Mexico City. Data came from the Mexico City Representative Diabetes Survey, conducted between May to June 2015. Participants (20–69 y, n = 1307) reported their diabetes condition, treatment, and outcomes. Fasting blood samples were collected and HbA1c, blood glucose, and blood lipids were determined. We used multivariate logistic regression to identify inequalities in diabetes prevalence and awareness. The overall prevalence of diabetes was 13.6% (95% CI: 11.7, 15.7). Of those living with diabetes, 70.5% were aware of their condition. Among those aware of their diabetes, around 10% to 65% received diabetes care according to international guidelines, and around 30% to 40% achieved HbA1c, LDL cholesterol, or blood pressure targets. Overall, only 4.1% of those aware of their diabetes achieved all treatment targets and 35.4% had never presented a diabetes complication. Diabetes prevalence was higher among older age groups and lower among the most educated. Having access to health care was associated with lower odds for diabetes and diabetes awareness. The low rates of diabetes awareness, treatment, and control highlight the urgent need of strengthening diabetes care in Mexico City. Full article

Open AccessArticle

Disrupted Self-Management and Adaption to New Diabetes Routines: A Qualitative Study of How People with Diabetes Managed Their Illness during the COVID-19 Lockdown

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Diabetology 2021, 2(1), 1-15; https://doi.org/10.3390/diabetology2010001 - 12 Jan 2021

Abstract

When societies went into the COVID-19 lockdown, the conditions under which people with diabetes managed their illness dramatically changed. The present study explores experiences of everyday life during the COVID-19 lockdown among people with diabetes, and how diabetes self-management routines were affected. The data consist of 20 interviews with adults with diabetes, focusing on experiences during the COVID-19 lockdown. The analysis showed that experiences of self-management during lockdown were diverse and that participants handled daily life changes in very different ways. The main changes in self-management related to physical activity and food intake, which decreased and increased, respectively, for many participants during lockdown. We found two main and significantly different overall experiences of everyday life while on lockdown: (1) A daily life significantly changed by the lockdown, causing disruption of diabetes self-management routines, and (2) a largely unaffected everyday life, enabling continuance of diabetes routines. Our findings showed that people with diabetes lacked information about strategies to self-manage diabetes during lockdown and would have benefited from guidance and support throughout the pandemic, or any other crisis, to maintain their diabetes self-management routines. Full article

Open AccessFeature PaperReview

Another Player in the Field: Involvement of Glycotoxins and Glycosative Stress in Insulin Secretion and Resistance

Paulo Matafome

Diabetology 2020, 1(1), 24-36; https://doi.org/10.3390/diabetology1010004 - 11 Nov 2020

Abstract

The term glycotoxins includes the group of advanced glycation end-products (AGEs) and their precursors, most of them highly reactive intermediary compounds, such as methylglyoxal (MG). Glycotoxins were initially thought to participate in the development of diabetic complications because of their increased formation from glucose. However, they also form and accumulate in tissues since the early stages of disease, such as metabolically unhealthy obesity and prediabetes. Such accumulation has been suggested to result from dysregulated activity of detoxification systems, such as the glyoxalase system, as well as increased dietary consumption, namely from high-glucose and high-fructose foods processed at high temperatures. Although some studies may have used supraphysiological doses, in vitro systems and animal models have shown glycotoxin-induced insulin resistance. Moreover, dietary glycotoxin restriction was shown to improve insulin resistance in humans and glyoxalase (GLO)-1 upregulation improved insulin sensitivity and metabolic function. This review summarizes the current knowledge about glycotoxin involvement in the development of insulin resistance, the mechanisms involved and the usefulness of GLO-1 modulation, and a possible therapeutic strategy to improve insulin sensitivity. Full article

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Open AccessEditorial

Diabetology: A New Online Diabetes Journal. What Role Can It Play in a Crowded Field?

Peter Clifton

Diabetology 2020, 1(1), 22-23; https://doi.org/10.3390/diabetology1010003 - 21 Oct 2020

Abstract

As a general physician with an interest in endocrinology, more than half of my patients have type 2 diabetes invariably accompanied by obesity, and in almost all cases at least one complication of diabetes [...] Full article

Open AccessFeature PaperReview

Sexual Dysfunction in Diabetic Women: An Update on Current Knowledge

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Diabetology 2020, 1(1), 11-21; https://doi.org/10.3390/diabetology1010002 - 10 Sep 2020

Abstract

Diabetes mellitus (DM) is one of the most common chronic diseases worldwide and its prevalence is expected to increase in the coming years. Therefore, updated knowledge of all diabetic complications and their management is essential for the proper treatment of these patients. Sexual dysfunctions are one of the long-term complications of DM in both genders. However, female sexuality is still a taboo and sexual concerns are often overlooked, underdiagnosed, and untreated. The aim of this review is to summarize the current knowledge on the relationship between sexual function and DM in women. In particular, we evaluated the prevalence, etiology, diagnostic approaches, and current treatment options of female sexual dysfunction (FSD) in diabetic patients. Full article

(This article belongs to the Special Issue Gender Difference in Diabetes)

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Open AccessArticle

Sex-Gender Differences in Diabetic Retinopathy

Maria Antonietta Fois

and

Diabetology 2020, 1(1), 1-10; https://doi.org/10.3390/diabetology1010001 - 20 Apr 2020

Cited by 2

Abstract

Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20–64 years old. The aim of this study was to investigate, in a multicenter retrospective cross-sectional study, sex-gender difference in DR in a large sample of type 2 diabetic patients (T2DM). 20,611 T2DM regularly attending the units for the last three years were classified as having: (a) No DR (NDR), (b) nonproliferative DR (NPDR), or (c) preproliferative/proliferative DR (PPDR). DR of all grades was present in 4294 T2DM (20.8%), with a significant higher prevalence in men as compared to women (22.0% vs. 19.3% p < 0.0001). Among DR patients, both NPDR and PPDR were significantly more prevalent in men vs. women (p = 0.001 and p = 0.0016, respectively). Women had similar age and BMI, but longer diabetes duration, worse glycemic metabolic control, and more prevalence of hypertension and chronic renal failure (CRF) of any grade vs. men. No significant differences between sexes were evident in term of drug therapy for diabetes and associate pathologies. Conclusions: In this large sample of T2DM, men show higher prevalence of DR vs. women, in spite of less represented risk factors, suggesting that male sex per se might be a risk factor for DR development. Full article

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