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Diabetes Therapy: From Bench to Bedside
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Diabetes Therapy: From Bench to Bedside

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (20 September 2023) | Viewed by 5273

Special Issue Editor

Dr. Basilio Pintaudi

E-Mail Website
Guest Editor
Diabetes Center, Niguarda Hospital, Piazza Ospedale Maggiore, 3 - 20162 Milan, Italy
Interests: GDM screening; GDM diagnosis; technology in pregnancy; pharmacological treatment in pregnancy; nutraceuticals; therapy for type 1 and type 2 diabetes; guidelines
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Due to its incidence and prevalence, diabetes poses a global challenge to health systems. People with diabetes can suffer major repercussions, and the costs associated with the disease are significant. Important therapeutic innovations, especially technological ones, are currently available for type 1 diabetes. For type 2 diabetes, a considerable number of drugs have been introduced, some of which have also been shown to greatly affect cardiovascular and renal parameters.

The objective of this Special Issue is to investigate pharmacological and non-pharmacological therapies in the context of treating type 1 and type 2 diabetes mellitus. Therefore, we welcome clinical intervention studies, observational real-world studies and meta-analyses, as well as studies reporting patient outcomes.

Dr. Basilio Pintaudi
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. Journal of Clinical Medicine 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

  • type 1 diabetes
  • type 2 diabetes
  • technology
  • pharmacological and non-pharmacological therapies
  • drugs

Published Papers (3 papers)

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Research

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13 pages, 2705 KiB  
Article
Real-World Retrospective Study into the Effects of Oral Semaglutide (As a Switchover or Add-On Therapy) in Type 2 Diabetes
by Riccardo Candido, Sara Gaiotti, Fabiola Giudici, Barbara Toffoli, Federica De Luca, Valerio Velardi, Alessandra Petrucco, Chiara Gottardi, Elena Manca, Iris Buda, Bruno Fabris and Stella Bernardi
J. Clin. Med. 2023, 12(18), 6052; https://doi.org/10.3390/jcm12186052 - 19 Sep 2023
Cited by 7 | Viewed by 1861
Abstract
(1) Background: Oral semaglutide represents the first oral GLP-1 RA approved for the treatment of type 2 diabetes mellitus (T2DM). This real-world retrospective study aimed at evaluating its effectiveness and tolerability in the treatment of patients with T2DM when patients switched from a [...] Read more.
(1) Background: Oral semaglutide represents the first oral GLP-1 RA approved for the treatment of type 2 diabetes mellitus (T2DM). This real-world retrospective study aimed at evaluating its effectiveness and tolerability in the treatment of patients with T2DM when patients switched from a glucose-lowering agent to it and when it was added to the usual therapy. (2) Methods: Adult patients with T2DM taking oral semaglutide and followed in the ASUGI Diabetes Center were identified with the use of electronic medical records between October 2022 and May 2023. (3) Results: A total of 129 patients were recruited. The median follow-up was 6 months. Be it as a switchover or as an add-on therapy, oral semaglutide significantly reduced HbA1c and BMI. Switching from DPPIV inhibitors to oral semaglutide was associated with a significant reduction in HbA1c and BMI, switching from SGLT2 inhibitors was associated with a significant reduction in HbA1c, and switching from sulphonylureas was associated with a significant reduction in BMI. The median HbA1c change was associated with baseline HbA1c. SBP significantly decreased in the add-on group. Oral semaglutide was well tolerated. (4) Conclusions: This study shows that in the real-world setting, oral semaglutide is effective and safe as a switchover or as an add-on therapy for the treatment of T2DM. Full article
(This article belongs to the Special Issue Diabetes Therapy: From Bench to Bedside)
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12 pages, 532 KiB  
Article
High Prevalence of Severe Hepatic Fibrosis in Type 2 Diabetic Outpatients Screened for Non-Alcoholic Fatty Liver Disease
by Clelia Asero, Annalisa Giandalia, Irene Cacciola, Carmela Morace, Giuseppe Lorello, Amalia Rita Caspanello, Angela Alibrandi, Giovanni Squadrito and Giuseppina T. Russo
J. Clin. Med. 2023, 12(8), 2858; https://doi.org/10.3390/jcm12082858 - 13 Apr 2023
Cited by 1 | Viewed by 1531
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is a highly frequent condition in patients with type 2 diabetes (T2D), but the identification of subjects at higher risk of developing the more severe forms remains elusive in clinical practice. The aim of this study was [...] Read more.
Background: Non-alcoholic fatty liver disease (NAFLD) is a highly frequent condition in patients with type 2 diabetes (T2D), but the identification of subjects at higher risk of developing the more severe forms remains elusive in clinical practice. The aim of this study was to evaluate the occurrence and severity of liver fibrosis and its predictive factors in T2D outpatients without a known history of chronic liver disease by using recommended non-invasive methods. Methods: Consecutive T2D outpatients underwent a set of measurements of clinical and laboratory parameters, FIB-4 score (Fibrosis-4 index), and liver stiffness with controlled attenuation-parameter (CAP) performed by transient elastography (FibroScan) after excluding previous causes of liver disease. Results: Among the 205 T2D outpatients enrolled in the study (median age: 64 years, diabetes duration: 11 years, HbA1c: 7.4%, and BMI: 29.6 kg/m2), 54% had high ALT and/or AST levels, 15.6% had liver stiffness value > 10.1 kPa (severe fibrosis), 55.1% had CAP values > 290 dB/m (severe steatosis), and FIB-4 score was >2 in 11.2% of subjects (>2.67 in 15 subjects). Moreover, 49 (23.9%) T2D patients had clinically meaningful liver harm, with either a FIB-4 score > 2 and/or FibroScan > 10.1 kPa. At regression analysis, BMI, HbA1c, creatinine, and triglycerides values were independent predictors of liver fibrosis. Conclusions: Liver fibrosis is a frequent finding in T2D outpatients without a known history of liver disease, especially in those with obesity, hypertriglyceridemia, worse glycemic control, and high creatinine levels. Full article
(This article belongs to the Special Issue Diabetes Therapy: From Bench to Bedside)
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Other

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22 pages, 2230 KiB  
Systematic Review
Association of Sodium-Glucose Cotransporter 2 Inhibitors with Osteomyelitis and Other Lower Limb Safety Outcomes in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
by Alessandro Nani, Federica Carrara, Chiara Maria Eleonora Paulesu, Chiara Dalle Fratte, Matteo Padroni, Silvia Enisci, Maria Concetta Bilancio, Maria Silvia Romio, Federico Bertuzzi and Basilio Pintaudi
J. Clin. Med. 2023, 12(12), 3958; https://doi.org/10.3390/jcm12123958 - 9 Jun 2023
Viewed by 1429
Abstract
Our aim was to evaluate osteomyelitis and other major lower limb safety outcomes (i.e., peripheral artery disease or PAD, ulcers, atraumatic fractures, amputations, symmetric polyneuropathy, and infections) in patients affected by type 2 diabetes mellitus (T2DM) and treated with sodium-glucose cotransporter 2 inhibitors [...] Read more.
Our aim was to evaluate osteomyelitis and other major lower limb safety outcomes (i.e., peripheral artery disease or PAD, ulcers, atraumatic fractures, amputations, symmetric polyneuropathy, and infections) in patients affected by type 2 diabetes mellitus (T2DM) and treated with sodium-glucose cotransporter 2 inhibitors (SGLT2-is). We thus performed a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing SGLT2-is at approved doses for T2DM with a placebo or standard of care. MEDLINE, Embase, and Cochrane CENTRAL were searched through August 2022. Separate intention-to-treat analyses were implemented for each molecule to calculate Mantel-Haenszel risk ratios (RRMH) with 95% confidence intervals (CIs) through a random-effects model. We processed data from 42 RCTs for a total of 29,491 and 23,052 patients, respectively assigned to SGLT2-i and comparator groups. SGLT2-is showed a pooled neutral effect on osteomyelitis, PAD, fractures, and symmetric polyneuropathy, whereas slightly deleterious sway on ulcers (RRMH 1.39 [1.01–1.91]), amputations (RRMH 1.27 [1.04–1.55]), and infections (RRMH 1.20 [1.02–1.40]). In conclusion, SGLT2-is appear to not significantly interfere with the onset of osteomyelitis, PAD, lower limb fractures, or symmetric polyneuropathy, even though the number of these events proved consistently higher in the investigational groups; otherwise, local ulcers, amputations, and overall infections may be favoured by their employment. This study is registered with the Open Science Framework (OSF). Full article
(This article belongs to the Special Issue Diabetes Therapy: From Bench to Bedside)
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