Dear Colleagues,

Energy metabolism is the process of generating energy (ATP) from nutrients, mainly in the form of sugars and fatty acids. The process comprises a series of interrelated pathways that can function with or without oxygen. The capacity of a cell to perform vital functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability all require energy in the form of ATP. Skeletal muscles represent the largest insulin-sensitive tissue in the body (40%) and are the primary site for insulin-stimulated glucose usage at rest and glucose and fatty acids utilisation during muscle contraction. The disruption of myocardial and skeletal muscle energy metabolism in metabolic syndromes such as obesity and diabetes are associated with various health problems along with decreased muscle mass and strength, impaired mobility, and fatigue symptoms. There is also a financial burden on the national health services as, on average, people with diagnosed type 2 diabetes (T2DM) have medical expenditures several times higher than what expenditures would be in the absence of diabetes.

In this background, the ability to address the presence of impaired energy metabolism in various pathological conditions would represent not only an ethical act but would also provide better management of the country's finances.

Being physically active and consuming a diet lower in saturated fats and refined sugars (non-pharmacological interventions) is good for T2DM as they improve blood glucose control, reduce cardiovascular risk factors, contribute to weight loss, and improve well-being.

Along with insulin therapy that helps maintain glucose homeostasis, numerous pharmacological approaches for treating T2DM have also become available in recent years. For instance, metformin is the most common medicine for T2DM.

Contributions to the field of restoring muscle energy metabolism in pathological conditions are welcome, which can be extended beyond T2DM such as sepsis, inflammation, ageing, or immobilisation through physiological and pharmacological interventions.

Dr. Dumitru Constantin-Teodosiu
Guest Editor

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• skeletal muscle
• energy
• impaired metabolism
• diseases
• interventions