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Metabolites
Special Issues
Diabetes and Metabolic Diseases: From Prevention to Clinical Management
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Diabetes and Metabolic Diseases: From Prevention to Clinical Management

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Endocrinology and Clinical Metabolic Research".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 9631

Special Issue Editors

Dr. Davide Masi

E-Mail Website
Guest Editor
Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
Interests: type 2 diabetes; obesity; gut microbiome; metabolic dysfunction-associated steatotic liver disease (MASLD)
Dr. Renata Risi

E-Mail Website
Guest Editor
Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
Interests: obesity; autoimmune diabetes; MASLD; type 2 diabetes

Special Issue Information

Dear Colleagues,

This Special Issue, entitled "Diabetes and Metabolic Diseases: From Prevention to Clinical Management", aims to thoroughly explore the complex landscape of diabetes and metabolic disorders. It sheds light on key aspects, ranging from preventive measures to therapeutic solutions. Given the intertwined nature of obesity and diabetes, both of which are escalating to pandemic levels, there is an urgent call for comprehensive approaches that cover prevention, early detection, and targeted treatments.

Prevention strategies take the forefront, recognizing the pivotal role of lifestyle changes like dietary adjustments and increased physical activity in halting the progression of these disorders. Early detection plays a crucial role in intervening promptly in order to slow down disease advancement and prevent complications. The issue delves into screening methods and diagnostic tools which can enable the early identification of individuals at risk.

Therapeutic options are varied and tailored to suit each patient's unique needs, considering the diverse nature of diabetes and metabolic diseases. From dietary manipulations like nutritional ketosis to medications targeting feeding behavior and the incretin system, the importance of personalized treatment approaches is underscored.

Furthermore, the issue emphasizes the significance of holistic management strategies. This includes integrating pharmacotherapy with lifestyle adjustments, patient education, and psychosocial support in order to optimize outcomes and improve the quality of life for those dealing with type 2 diabetes and obesity.

Dr. Davide Masi
Dr. Renata Risi
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. Metabolites is an international peer-reviewed open access monthly 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 2700 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

  • obesity
  • nutritional ketosis
  • dietary manipulations
  • therapeutic inertia
  • type 2 diabetes
  • gut microbiome
  • incretins
  • hormone regulation

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Published Papers (5 papers)

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Research

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17 pages, 1923 KiB  
Article
Unveiling Silent Atherosclerosis in Type 1 Diabetes: The Role of Glycoprotein and Lipoprotein Lipidomics, and Cardiac Autonomic Neuropathy
by Sara de Lope Quiñones, Manuel Luque-Ramírez, Antonio Carlos Michael Fernández, Alejandra Quintero Tobar, Jhonatan Quiñones-Silva, María Ángeles Martínez García, María Insenser Nieto, Beatriz Dorado Avendaño, Héctor F. Escobar-Morreale and Lía Nattero-Chávez
Metabolites 2025, 15(1), 55; https://doi.org/10.3390/metabo15010055 - 16 Jan 2025
Viewed by 958
Abstract
Introduction: This study aimed to evaluate whether glycoprotein and lipoprotein lipidomics profiles could enhance a clinical predictive model for carotid subclinical atherosclerosis in patients with type 1 diabetes (T1D). Additionally, we assessed the influence of cardiac autonomic neuropathy (CAN) on these predictive models. [...] Read more.
Introduction: This study aimed to evaluate whether glycoprotein and lipoprotein lipidomics profiles could enhance a clinical predictive model for carotid subclinical atherosclerosis in patients with type 1 diabetes (T1D). Additionally, we assessed the influence of cardiac autonomic neuropathy (CAN) on these predictive models. Methods: We conducted a cross-sectional study including 256 patients with T1D. Serum glycoprotein and lipoprotein lipidomics profiles were determined using 1H-NMR spectroscopy. Subclinical atherosclerosis was defined as carotid intima-media thickness (cIMT) ≥ 1.5 mm. CAN was identified using the Clarke score. Predictive models were built and their performance evaluated using receiver operating characteristic curves and cross-validation. Results: Subclinical atherosclerosis was detected in 32% of participants. Patients with both CAN and atherosclerosis were older, had a longer duration of diabetes, and were more likely to present with bilateral carotid disease. Clinical predictors such as age, duration of diabetes, and smoking status remained the strongest determinants of subclinical atherosclerosis [AUC = 0.88 (95%CI: 0.84–0.93)]. While glycoprotein and lipoprotein lipidomics profiles were associated with atherosclerosis, their inclusion in the clinical model did not significantly improve its diagnostic performance. Stratification by the presence of CAN revealed no impact on the model’s ability to predict subclinical atherosclerosis, underscoring its robustness across different risk subgroups. Conclusions: In a cohort of patients with T1D, subclinical atherosclerosis was strongly associated with traditional clinical risk factors. Advanced glycoprotein and lipoprotein lipidomics profiling, although associated with atherosclerosis, did not enhance the diagnostic accuracy of predictive models beyond clinical variables. The predictive model remained effective even in the presence of CAN, highlighting its reliability as a screening tool for identifying patients at risk of subclinical atherosclerosis. Full article
(This article belongs to the Special Issue Diabetes and Metabolic Diseases: From Prevention to Clinical Management)
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12 pages, 863 KiB  
Article
A Ketogenic Diet Followed by Gradual Carbohydrate Reintroduction Restores Menstrual Cycles in Women with Polycystic Ovary Syndrome with Oligomenorrhea Independent of Body Weight Loss: Results from a Single-Center, One-Arm, Pilot Study
by Rebecca Rossetti, Vittoria Strinati, Alessandra Caputi, Renata Risi, Maria Letizia Spizzichini, Alessandro Mondo, Lorenzo Spiniello, Carla Lubrano, Antonella Giancotti, Dario Tuccinardi, Lucio Gnessi and Mikiko Watanabe
Metabolites 2024, 14(12), 691; https://doi.org/10.3390/metabo14120691 - 8 Dec 2024
Viewed by 4383
Abstract
Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. [...] Read more.
Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. Methods: Eighteen patients with PCOS phenotype A were enrolled: 28% were of normal weight, 28% were overweight, and 44% had obesity. All participants followed a KD without meal replacements for 45 days. After this period, patients underwent gradual carbohydrate reintroduction over 45 days, and thereafter healthy eating indications were given. Twelve patients completed the study. The patients were assessed at baseline and after 6 months. Anthropometric data, body composition, pelvic ultrasound, blood chemistry, hirsutism, and menstrual cycles frequency were recorded; Results: Besides improvement in anthropometric parameters, menstrual cycles (p 0.012), ovarian volume (p 0.029), FSH (p 0.05), LH (p 0.037), and progesterone (p 0.017) improved independently of weight or fat loss. However, testosterone and hirsutism improvements were influenced by weight and fat mass reduction. Conclusions: Our study showed that a KD followed by gradual carbohydrate reintroduction in PCOS has beneficial effects medium term, mostly independent of body weight loss, even in normal-weight women, suggesting that nutritional ketosis exerts beneficial effects per se. Full article
(This article belongs to the Special Issue Diabetes and Metabolic Diseases: From Prevention to Clinical Management)
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Review

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22 pages, 3818 KiB  
Review
Navigating Diabetes in Pregnancy: Critical Approaches to Mitigate Risks and Improve Outcomes for Mother and Child
by Zoe Paige Garvey, Abhishek Gupta, Nicole Taylor, Mahesh Thirunavukkarasu and Nilanjana Maulik
Metabolites 2025, 15(3), 180; https://doi.org/10.3390/metabo15030180 - 6 Mar 2025
Viewed by 859
Abstract
With the increasing prevalence of diabetes and its growing impact on maternal and fetal health, management during pregnancy has become critical. This review describes the pathophysiology of insulin resistance during pregnancy, adverse outcomes correlated with diabetic pregnancies, and current management strategies. We investigate [...] Read more.
With the increasing prevalence of diabetes and its growing impact on maternal and fetal health, management during pregnancy has become critical. This review describes the pathophysiology of insulin resistance during pregnancy, adverse outcomes correlated with diabetic pregnancies, and current management strategies. We investigate two leading approaches to managing pregnant patients with diabetes—lifestyle intervention and drug treatment. Lifestyle intervention, including dietary counseling, exercise regimens, patient education, and self-administered blood glucose monitoring, has demonstrated promising results in the management and prevention of gestational diabetes mellitus (GDM). Early intervention and treatment of at-risk patients have been critical for positive outcomes. Drug treatment, focusing on the utilization of insulin, insulin analogs, and antihyperglycemic agents has shown efficacy in achieving glycemic control and improving maternal and neonatal outcomes. These findings indicate that a combination of early lifestyle intervention and targeted drug treatment yields the most benefit in managing diabetes in pregnancy. To augment treatment, continuous glucose monitoring and telemedicine have become valuable tools in managing diabetes during pregnancy. Future research should aim to develop more effective antihyperglycemic agents, improve telehealth accessibility, and enhance preconception care for women at risk of developing GDM. By addressing these areas, we can significantly reduce the adverse outcomes associated with diabetes in pregnancy and improve overall maternal and fetal health. Full article
(This article belongs to the Special Issue Diabetes and Metabolic Diseases: From Prevention to Clinical Management)
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15 pages, 285 KiB  
Review
Metabolomics in Pathogenic Pathways and Targeted Therapies for Diabetic Neuropathy: A Comprehensive Review
by Cornelia Bala, Adriana Rusu, Dana Mihaela Ciobanu, Gabriela Roman and Anca Elena Crăciun
Metabolites 2025, 15(2), 86; https://doi.org/10.3390/metabo15020086 - 1 Feb 2025
Viewed by 900
Abstract
Introduction and objective: This literature review aims to provide an overview of the progress in metabolomic assessment in animal and cell models and in humans with diabetic neuropathy (DN). Methods: Metabolomics has emerged as an important approach for investigating, identifying, and describing biomarkers [...] Read more.
Introduction and objective: This literature review aims to provide an overview of the progress in metabolomic assessment in animal and cell models and in humans with diabetic neuropathy (DN). Methods: Metabolomics has emerged as an important approach for investigating, identifying, and describing biomarkers related to DN. None has yet been validated for use in clinical practice. Results: DN induced significant alterations in energy metabolism and carbohydrates, lipids, amino acids, peptides, and proteins. Several treatments for DN, evaluated using metabolomics, were proved to have promising results. Conclusions: The ideal metabolite or set of metabolites that could be used as biomarkers should identify patients with diabetes prone to develop DN or those prone to progress to severe forms of sensory loss, associated with risk of ulcerations and amputation. Another potential use of a metabolite might be as an indicator of treatment response in clinical trials using agents with potential disease-modifying properties. Full article
(This article belongs to the Special Issue Diabetes and Metabolic Diseases: From Prevention to Clinical Management)
20 pages, 363 KiB  
Review
Eating- and Weight-Related Disorders in the Armed Forces
by Hubertus Himmerich, Davide Gravina, Inga Schalinski, Gerd-Dieter Willmund, Peter Lutz Zimmermann, Johanna Louise Keeler and Janet Treasure
Metabolites 2024, 14(12), 667; https://doi.org/10.3390/metabo14120667 - 1 Dec 2024
Viewed by 1804
Abstract
Background/Objectives: Like in the general population, the prevalences of eating- and weight-related health issues in the armed forces are increasing. Relevant medical conditions include the eating disorders (EDs) anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder (ARFID), as [...] Read more.
Background/Objectives: Like in the general population, the prevalences of eating- and weight-related health issues in the armed forces are increasing. Relevant medical conditions include the eating disorders (EDs) anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder (ARFID), as well as body dysmorphic disorder, muscle dysmorphia, and the relative energy deficiency in sport (RED-S) syndrome. Methods: We performed a narrative literature review on eating- and weight-related disorders in the armed forces. Results: Entry standards might exclude people with obesity, with EDs, or at high risk for EDs from entering the armed forces for military reasons and to protect the individual’s health. Relevant potential risk factors of eating- and weight-related disorders in the military are the emphasis on appearance and fitness in the military, high levels of stress, military sexual trauma, post-traumatic stress disorder, deployment, relocation, long commutes, consumption of ultra-processed foods and beverages, limitations on food selection and physical exercise, and intensive combat training and field exercises. Eating- and weight-related disorders negatively impact professional military appearance and lead to problems with cardiorespiratory and neuromuscular fitness; daytime sleepiness; and a higher risk of musculoskeletal injuries, and other physical and mental health problems. Current and potential future therapeutic options include occupational health measures, psychosocial therapies, neuromodulation, and drug treatments. Conclusions: Even though randomized controlled trials (RCTs) have been performed to test treatments for obesity in the armed forces, RCTs for the treatment of EDs, body dysmorphic disorder, muscle dysmorphia, and RED-S syndrome are lacking in the military context. Full article
(This article belongs to the Special Issue Diabetes and Metabolic Diseases: From Prevention to Clinical Management)
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