Advances in the Diagnosis and Pathogenesis of Diabetes

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 16484

Special Issue Editors


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Guest Editor

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Guest Editor
Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
Interests: oral pathology; immunology; dentoalveolar surgery; implantology; diabetes

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Guest Editor
Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
Interests: lipotoxicity; chronic kidney disorders; diabetes; renal biomarkers, cardiovascular disease

Special Issue Information

Dear Colleagues,

Diabetes Mellitus is a metabolic disease whose prevalence is on the rise worldwide. It includes type 1, type 2, and gestational diabetes and some rare forms such as monogenic diabetes syndrome or drug-induced diabetes, the precursory condition of this disease being pre-diabetes. In spite of the high prevalence, most affected subjects are unaware of the disease, thus leading to progression and further complications such as neuropathy, retinopathy, nephropathy, cardiovascular disease and complications in the oral cavity (increased infection risk, delayed wound healing, periodontal disease, halitosis, dental caries, salivary and taste dysfunction, tongue abnormalities, oral cancer, temporomandibular disorders) that can further affect the patients’ quality of life.

Both pre-diabetes and diabetes are most frequently diagnosed by analyzing glucose levels, through fasting plasma glucose test and oral glucose tolerance test however, these methods do not distinguish between type 1 and 2 diabetes.

Other minimally invasive approaches include breath analysis, SwEatch, the glucose-sensing patch, and eyeglass biosensor to name a few. As such, novel diagnostic methods are necessary to identify and monitor various types of modifications before disease onset. Progress in selective biomarker signatures detection could support the prompt identification and classification of diabetic conditions and treatments, to prevent and reverse pre-diabetes. Moreover, diagnostic accuracy is thorough out the monitoring phase of treatment in order to assess efficacy and combat complications.

This special issue aims to offer an update on the current knowledge of diagnostic methods of diabetes, complications of diabetes, but also methods of monitoring treatment effectiveness.

In this special issue, we welcome researchers to submit either original research or reviews for publication in the upcoming Special Issue of the Diagnostics journal, especially, but not limited to, theoretical and clinical studies on new and established diagnostic methods and treatment effectiveness evaluation.

Prof. Dr. Liliana-Georgeta Foia
Dr. George Alexandru Maftei
Dr. Cristiana Elena Vlad
Guest Editors

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. Diagnostics is an international peer-reviewed open access semimonthly 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

  • biochemical diagnosis
  • DNA
  • diabetic complications
  • diabetic foot ulcer
  • epigenetic modifications
  • oral manifestations of diabetes

Published Papers (5 papers)

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Research

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15 pages, 783 KiB  
Article
Lipid Profile Paradox: Investigating Improved Lipid Levels in Diabetic Mellitus Patients with Foot Ulcer Infections—A Prospective Descriptive Study
by Andrei Ardelean, Andreea-Adriana Neamtu, Diana-Federica Balta, Carmen Neamtu, Dan Goldis, Mihai Rosu, Alexandru Nesiu, Silviu Moldovan, Cristi Tarta and Bogdan Dan Totolici
Diagnostics 2023, 13(23), 3531; https://doi.org/10.3390/diagnostics13233531 - 25 Nov 2023
Cited by 2 | Viewed by 1185
Abstract
Type 2 diabetes mellitus (DM) is a chronic metabolic disorder posing multifaceted challenges to global public health. Among its numerous complications, infected diabetic foot ulcers (IDFUs) represent a particularly debilitating consequence. Beyond cardiovascular implications, there is an emerging understanding of the interconnectedness among [...] Read more.
Type 2 diabetes mellitus (DM) is a chronic metabolic disorder posing multifaceted challenges to global public health. Among its numerous complications, infected diabetic foot ulcers (IDFUs) represent a particularly debilitating consequence. Beyond cardiovascular implications, there is an emerging understanding of the interconnectedness among IDFUs, neuropathy, atherosclerosis, and dyslipidemia. IDFUs, peripheral neuropathy, and atherosclerosis share common risk factors and mechanistic pathways. The primary objective of this study was to characterize the lipid profiles in DM patients with IDFUs, comparing them with DM patients without foot ulcers, and with a control group of healthy subjects. The secondary objectives included evaluating apolipoprotein E (ApoE) levels across these study groups and comparing lipid profiles within IDFU subgroups. A total of 160 patients were assessed for this study. After applying exclusion criteria, 140 participants were included, divided into three groups: Group IDFU (80 patients with IDFUs), Group DM (32 patients with DM but no foot ulcers), and Group Controls (28 healthy controls). Compared to Group DM, Group IDFU demonstrated lower levels of high-density lipoprotein cholesterol (HDL-C) (30.9 ± 12.6 mg/dL vs. 40.8 ± 16.6 mg/dL, p = 0.002), but improved levels of ApoE (160.9 ± 68.4 mg/dL vs. 197.2 ± 69.6 mg/dL, p = 0.01), triglycerides (TG) (126.9 ± 56.2 mg/dL vs. 165.8 ± 79.0 mg/dL, p = 0.004), low-density lipoprotein cholesterol (LDL-C) (84.2 ± 32.3 mg/dL vs. 92.3 ± 39.3 mg/dL, p = 0.1), and total cholesterol (133.6 ± 43 mg/dL vs. 164.6 ± 44.4 mg/dL, p = 0.002). The IDFU patients exhibit improved lipid profiles, excepting HDL-C, which is unusual because IDFU follows complications related to dyslipidemia for DM patients. Anemia, impaired renal function, and elevated TG levels were identified as biomarkers for mortality among patients with IDFUs. The data suggest that a lower level of HDL-C and an improved lipid profile may indicate a systemic end-stage disease manifestation in DM patients with IDFUs. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Pathogenesis of Diabetes)
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12 pages, 668 KiB  
Article
Influence of Diabetes Mellitus and Smoking on Pro- and Anti-Inflammatory Cytokine Profiles in Gingival Crevicular Fluid
by Liliana Pasarin, Maria-Alexandra Martu, Oana Elena Ciurcanu, Elena Odette Luca, Mihaela Salceanu, Diana Anton, Cristian Martu, Silvia Martu and Irina Mihaela Esanu
Diagnostics 2023, 13(19), 3051; https://doi.org/10.3390/diagnostics13193051 - 25 Sep 2023
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Abstract
Smoking and diabetes mellitus have been recognized as significant modifying factors of the evolution of periodontitis, being considered at the moment as descriptive factors in the periodontitis grading system. The purpose of this study was to assess the consequence of smoking, type 2 [...] Read more.
Smoking and diabetes mellitus have been recognized as significant modifying factors of the evolution of periodontitis, being considered at the moment as descriptive factors in the periodontitis grading system. The purpose of this study was to assess the consequence of smoking, type 2 diabetes, and the combination of these two factors on clinical periodontal parameters, on the levels of gingival crevicular fluid (GCF), and also on ratios of pro-inflammatory and anti-inflammatory cytokines by using a commercially available kit-based multiplex fluorescent immunoassay. The study was carried out on 124 volunteers (control (C) group = 29, diabetes mellitus (DM) group = 32, smoking (S) group = 31, and S + DM group = 32). Total mean bleeding on probing was significantly lower in the S and S + DM groups, compared to that of the other groups (p < 0.05). Total amounts of TGF-β, MIP-1α, IL-6, IL-2, and IL-17 were significantly increased in the periodontally healthy sites of diabetes patients (p < 0.05), compared to those of the controls. Systemically healthy smoking patients had higher values of GM-CSF, TGF-β, IL-4, TNF-α, IL-5, and IL-7, while diabetic smoking patients showed higher values of IL-4, TGF-β, and MIP-1α. In smoking and systemically healthy patients, IL-23, IL-7, and IL-12 showed increased concentrations, while concentrations of TGF-β, MIP-1α, IL-2, IL-7, IL-12, IL-17, IL-21, and IL-23 were higher in smoking DM patients. In conclusion, in our study, diabetes mellitus induced a general pro-inflammatory state, while smoking mainly stimulated immunosuppression in the periodontal tissues of periodontitis subjects. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Pathogenesis of Diabetes)
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12 pages, 1713 KiB  
Article
Pentraxin-3 and Other Inflammatory Markers for an Infected Diabetic Foot Ulcer Diagnosis: A Prospective Study
by Andrei Ardelean, Diana-Federica Balta, Carmen Neamtu, Adriana Andreea Neamtu, Mihai Rosu, Luminita Pilat, Silviu Moldovan, Cristi Tarta and Bogdan Totolici
Diagnostics 2023, 13(14), 2366; https://doi.org/10.3390/diagnostics13142366 - 13 Jul 2023
Cited by 1 | Viewed by 1266
Abstract
Strategies have been researched and implemented to reduce the number of people with diabetic foot ulcers (DFUs). One problem is the accurate assessment of DFU severity, which is the main factor in resource allocation and treatment choice. The primary objective of this study [...] Read more.
Strategies have been researched and implemented to reduce the number of people with diabetic foot ulcers (DFUs). One problem is the accurate assessment of DFU severity, which is the main factor in resource allocation and treatment choice. The primary objective of this study was to assess pentraxin-3 as a biomarker of an infected DFU (IDFU), the limb amputation level prognosis, and patient survival. The secondary objectives were to evaluate and compare other markers, including white blood cells (WBCs), C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT), for identifying IDFUs. Over a period of two years, 145 patients were followed; 131 of these were analyzed for this study. Pentraxin-3 was found to be a good predictor of death (p = 0.047). A comparison between IDFUs and DFUs revealed the following differences: PCT had the highest AUROC of 0.91, sensitivity of 93.7, and specificity of 83.3%. CRP had a cutoff value of 226 mg/L, an AUROC of 0.89, a sensitivity of 95.5%, and a specificity of 83.3%. Fibrinogen had an AUROC of 0.87 at a cutoff value of 5.29 g/L, with a good sensitivity and specificity of 85% and 87%, respectively. ESR had a cutoff value of 46 mm/h, an AUROC of 85%, a sensitivity of 83.7%, and a specificity of 83.3%. Pentraxin-3 showed promising results in predicting IDFUs and DFUs, and it served as a marker for the risk of death in IDFU patients during the 6 month follow-up. Other markers, including CRP, PCT, ESR, and fibrinogen, were more effective in differentiating between IDFUs and DFUs. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Pathogenesis of Diabetes)
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Review

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13 pages, 2277 KiB  
Review
Continuous Glucose Monitoring in Transient Neonatal Diabetes Mellitus—2 Case Reports and Literature Review
by Tatiana Chisnoiu, Adriana Luminita Balasa, Larisia Mihai, Ancuta Lupu, Corina Elena Frecus, Irina Ion, Antonio Andrusca, Alexandru Cosmin Pantazi, Maria Nicolae, Vasile Valeriu Lupu, Constantin Ionescu, Cristina Maria Mihai and Simona Claudia Cambrea
Diagnostics 2023, 13(13), 2271; https://doi.org/10.3390/diagnostics13132271 - 4 Jul 2023
Cited by 4 | Viewed by 1620
Abstract
Neonatal diabetes mellitus is a rare genetic disease that affects 1 in 90,000 live births. The start of the disease is often before the baby is 6 months old, with rare cases of onset between 6 months and 1 year. It is characterized [...] Read more.
Neonatal diabetes mellitus is a rare genetic disease that affects 1 in 90,000 live births. The start of the disease is often before the baby is 6 months old, with rare cases of onset between 6 months and 1 year. It is characterized by low or absent insulin levels in the blood, leading to severe hyperglycemia in the patient, which requires temporary insulin therapy in around 50% of cases or permanent insulin therapy in other cases. Two major processes involved in diabetes mellitus are a deformed pancreas with altered insulin-secreting cell development and/or survival or faulty functioning of the existing pancreatic beta cell. We will discuss the cases of two preterm girls with neonatal diabetes mellitus in this research. In addition to reviewing the literature on the topic, we examined the different mutations, patient care, and clinical outcomes both before and after insulin treatment. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Pathogenesis of Diabetes)
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17 pages, 785 KiB  
Review
The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus—A Review
by Ioana Păunică, Marina Giurgiu, Anca Silvia Dumitriu, Stana Păunică, Anca Mihaela Pantea Stoian, Maria-Alexandra Martu and Cristian Serafinceanu
Diagnostics 2023, 13(4), 681; https://doi.org/10.3390/diagnostics13040681 - 11 Feb 2023
Cited by 24 | Viewed by 10351
Abstract
Periodontitis is a chronic inflammatory disease caused by the presence of a bacterial biofilm known as dental plaque. This biofilm affects the supporting apparatus of the teeth, especially the periodontal ligaments and the bone surrounding the teeth. Periodontal disease and diabetes seem to [...] Read more.
Periodontitis is a chronic inflammatory disease caused by the presence of a bacterial biofilm known as dental plaque. This biofilm affects the supporting apparatus of the teeth, especially the periodontal ligaments and the bone surrounding the teeth. Periodontal disease and diabetes seem to be interrelated and in a bidirectional relationship, and have been increasingly studied in recent decades. For example, diabetes mellitus has a detrimental effect on periodontal disease, increasing its prevalence, extent, and severity. In turn, periodontitis negatively affects glycemic control and the course of diabetes. This review aims to present the most recently discovered factors that contribute to the pathogenesis, therapy, and prophylaxis of these two diseases. Specifically, the article focuses on microvascular complications, oral microbiota, pro- and anti-inflammatory factors in diabetes, and periodontal disease. As presented in this review, these two diseases require specific/ complementary therapeutic solutions when they occur in association, with new clinical trials and epidemiological research being necessary for better control of this interdependent pathogenic topic. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Pathogenesis of Diabetes)
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