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Diabetes Mellitus and Emerging Health Challenges: A Multidisciplinary Perspective

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

Deadline for manuscript submissions: 10 June 2026 | Viewed by 1932

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Special Issue Editors

Dr. Katarzyna A. Majewska

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Guest Editor

Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznań, Poland
Interests: short stature; growth hormone; growth hormone therapy; obesity; insulin resistance; dysglycemia; type 1 diabetes; prediabetes; autoimmune thyroiditis
Special Issues, Collections and Topics in MDPI journals

Dr. Agnieszka Zawada

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Guest Editor

Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
Interests: type 1 diabetes mellitus; type 2 diabetes mellitus; diabetic complications; diabetes treatment; autoimmune diabetes

Special Issue Information

Dear Colleagues,

Diabetes mellitus remains a leading global health challenge, with rising prevalence among adults and children. Due to acute and chronic complications, it has profound implications for morbidity, mortality, and healthcare systems. Beyond glycemic control, diabetes is closely linked with cardiovascular disease, kidney dysfunction, neuropathy, retinopathy, infections, and impaired wound healing. The complexity of these complications underscores the need for a multidisciplinary approach to care, involving endocrinology, cardiology, nephrology, neurology, ophthalmology, and primary care. Diabetes can also affect cognitive functions and psychological well-being, thus requiring additional targeted support.

This Special Issue, titled “Diabetes Mellitus and Emerging Health Challenges: A Multidisciplinary Perspective”, aims to highlight advances in clinical management, prevention strategies, and integrated care models. Topics of interest include novel therapeutic approaches, biomarker-driven diagnostics, lifestyle interventions, comorbidity management, and health system responses to the diabetes epidemic.

We welcome original research, clinical studies, and reviews that contribute to improving outcomes and fostering holistic, patient-centered diabetes care.

Dr. Katarzyna A. Majewska
Dr. Agnieszka Zawada
Guest Editors

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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.

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Keywords

diabetes mellitus
type 1 diabetes
type 2 diabetes
diabetic complications
prediabetes
diabetes treatment
autoimmune diabetes

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Published Papers (4 papers)

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Research

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9 pages, 560 KB

Open AccessArticle

Patterns and Clinical Outcomes of Sitagliptin/Metformin Extended-Release in Internal Medicine: A Real-World Multicenter Italian Study

by Mariarosaria De Luca, Michele Arcopinto, Giosiana Bosco, Sebastiano Cicco, Francesco Di Giacomo Barbagallo, Chiara Giacinti, Marialuisa Sveva Marozzi, Maristella Salvatora Masala, Miriam Pinna, Giacomo Pucci, Andrea Salzano, Roberto Scicali, Alberto Maria Marra and Antonio Cittadini

J. Clin. Med. 2026, 15(3), 927; https://doi.org/10.3390/jcm15030927 - 23 Jan 2026

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Abstract

Background: In internal medicine, the management of type 2 diabetes mellitus (T2DM) is challenged by multimorbidity and polypharmacy. The fixed-dose combination of sitagliptin and extended-release metformin (SITA/MET ER) is a valuable option for frail and comorbid patients. Methods: This multicenter, retrospective, observational study involved five Italian Internal Medicine units. Consecutive patients with T2DM who initiated SITA/MET ER were included. Demographic, clinical, and laboratory data were collected at baseline (T0) and at follow-up (T1, 3–4 months). The primary endpoint was change in HbA1c; secondary endpoints included fasting plasma glucose (FPG), treatment adherence, adverse events, and modifications in concomitant antidiabetic therapies. Results: A total of 292 patients (mean age 70.8 ± 10.6 years; 43% female) were analyzed. At baseline, mean HbA1c was 7.4 ± 1.0% and FPG 150.2 ± 42.5 mg/dL, with significant reductions observed at follow-up (HbA1c 7.0 ± 0.8%, FPG 136.8 ± 29.6 mg/dL; both p < 0.05). SITA/MET ER was predominantly prescribed to patients with a complex clinical profile, as reflected by the high prevalence of microvascular (37%) and macrovascular (42%) complications. The use of sulfonylureas decreased from 11% to 3% (p < 0.001), while SGLT2 inhibitor and insulin use remained stable. Treatment adherence to SITA/MET ER was excellent, with full compliance reported and no adverse events recorded. Conclusions: In this real-world internal medicine study, SITA/MET ER improved glycemic control and was well tolerated among patients with complex clinical profiles. These findings support the role of SITA/MET ER as a flexible and practical therapeutic choice in this setting. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Emerging Health Challenges: A Multidisciplinary Perspective)

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13 pages, 416 KB

Open AccessFeature PaperArticle

Impaired Attention Functioning in Children and Adolescents with Obesity: Preliminary Results Based on the Computerized Continuous Performance Test

by Katarzyna Anna Majewska, Maia Stanisławska-Kubiak, Paulina Wais, Joanna Budzulak, Ewa Mojs and Andrzej Kędzia

J. Clin. Med. 2025, 14(24), 8656; https://doi.org/10.3390/jcm14248656 - 6 Dec 2025

Viewed by 423

Abstract

Background/Objectives: Attention is a fundamental cognitive parameter, essential for developmental processes. It enables the selective processing of environmental stimuli and guides behavioral responses. Obesity, apart from its broad influence on human somatic health, is also associated with mental and cognitive functioning. In childhood obesity, detailed attention assessment could help elucidate the relationship between the condition and cognitive development, and perhaps also help predict specific difficulties during treatment. The aim of the study was to investigate attention functioning in children and adolescents with obesity using the computerized continuous performance test (CPT). Methods: The study involved 71 children, including 23 with obesity and 48 healthy children with normal body weight. The MOXO CPT was used to assess attention parameters in all participants. The test covered four parameters: sustained attention, timing, impulsivity, and hyperactivity. Results: Children with obesity obtained significantly lower CPT results in terms of timing (p = 0.024), hyperactivity (p = 0.001), and impulsivity (p < 0.001), while the difference in sustained attention did not reach statistical significance (p = 0.074). Conclusions: Attention efficiency appears to be reduced in children with obesity compared with their healthy peers. Assessment of attention parameters in this group of patients could be valuable in the context of planning and implementing therapeutic interventions. Children with coexisting obesity and impaired attention functioning would probably require more assistance in following daily behavioral and nutritional recommendations. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Emerging Health Challenges: A Multidisciplinary Perspective)

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Review

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21 pages, 873 KB

Open AccessReview

Enhancing Primary Care Recognition of Type 1 Diabetes in Children: Diagnostic Challenges and Strategies to Prevent Diabetic Ketoacidosis

by Yung-Yi Lan, Rujith Kovinthapillai, Andrzej Kędzia and Elżbieta Niechciał

J. Clin. Med. 2026, 15(2), 533; https://doi.org/10.3390/jcm15020533 - 9 Jan 2026

Viewed by 358

Abstract

Timely recognition of type 1 diabetes (T1D) in children and adolescents is crucial to prevent acute complications such as diabetic ketoacidosis (DKA). This narrative review examines the pathophysiology, clinical presentation, and diagnostic challenges of childhood T1D, including the young age of onset, clinician training gaps, and overlapping symptomatology between T1D and other common pediatric illnesses. Despite increased awareness, a significant proportion of children still present with DKA at diagnosis due to misinterpretation of symptoms, such as polydipsia, polyuria, and weight loss. This work emphasizes the importance of early recognition, timely intervention, and the use of structured management algorithms for primary care clinicians. Strategies to reduce DKA incidence, based on existing literature, successful real-world examples, and current guidelines, include enhanced screening for high-risk populations, educational initiatives, and improved diagnostic protocols. By implementing systematic approaches and public health campaigns, healthcare providers can improve early T1D detection and prevent severe DKA complications, ultimately enhancing patient outcomes and reducing long-term morbidity. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Emerging Health Challenges: A Multidisciplinary Perspective)

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Other

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18 pages, 1731 KB

Open AccessSystematic Review

Continuous Glucose Monitoring in Non-ICU Hospitalized Adults with Type 2 Diabetes: A Systematic Review

by Darío Lara-Gálvez, Matilde Rubio-Almanza, Yolanda Aparicio-Ródenas, David Sanchis-Pascual, Pilar Masdeu-López-Cerón, Victor Pérez-Cervantes and Juan Francisco Merino-Torres

J. Clin. Med. 2026, 15(1), 34; https://doi.org/10.3390/jcm15010034 - 20 Dec 2025

Viewed by 541

Abstract

Background: Continuous glucose monitoring (CGM) may overcome the limitations of intermittent point-of-care (POC) testing by providing real-time glucose trends and reducing treatment delays. This study aimed to evaluate the efficacy of CGM versus POC capillary testing in improving glycemic control among hospitalized non-Intensive Care Unit (non-ICU) adults with type 2 diabetes mellitus (T2DM). Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. We searched PubMed for randomized controlled trials published in English or Spanish that compared CGM with POC testing in hospitalized non-ICU adults ≥ 18 years old with T2DM and assessed risk of bias using the Cochrane RoB2 tool. The primary outcome was time in range (TIR). Secondary outcomes included time below range (TBR), time above range (TAR), mean glucose (MG), and glycemic variability (GV). Results: Seven randomized controlled trials (RCTs) including 1106 patients were analyzed. CGM significantly improved TIR (mean difference [MD] +8.15%; 95% confidence interval [CI]: +5.76, +10.55; p < 0.001) and reduced TAR > 180 mg/dL (MD −7.11%; 95% CI: −9.43, −4.78; p < 0.001) and TAR > 250 mg/dL (MD −3.96%; 95% CI: −5.29, −2.62; p < 0.001) compared with POC testing. MG also decreased with CGM (MD −11.27 mg/dL; 95% CI: −14.74, −7.81; p < 0.001). A modest reduction in TBR <70 mg/dL was observed (MD −0.29%; p < 0.001), whereas no significant differences were found for TBR < 54 mg/dL or GV. Conclusions: CGM improves inpatient glycemic control in non-ICU adults with type 2 diabetes, demonstrating advantages over POC testing across multiple randomized trials. However, further multicenter research is needed to clarify workflow implications, cost-effectiveness, and optimal implementation strategies. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Emerging Health Challenges: A Multidisciplinary Perspective)

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