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Journal = Diabetology
Section = Diagnosis, Screening and Monitoring of Diabetes

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22 pages, 606 KB  
Article
Cerebrospinal Fluid Biomarkers of Neuroinflammation and Neuroplasticity in Type 2 Diabetes Mellitus: Association with Cognitive Performance
by César Mauricio Baracaldo Barrera, Martha Cecilia Jiménez Martínez and Sandra Rojas Vega
Diabetology 2026, 7(8), 150; https://doi.org/10.3390/diabetology7080150 - 7 Aug 2026
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Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is associated with cognitive decline, potentially mediated by neuroinflammatory processes and altered neuroplasticity. This study investigated cerebrospinal fluid (CSF) biomarkers of neuroinflammation and neuroplasticity in T2DM individuals versus controls, and their relationship with cognitive performance. Methods: This [...] Read more.
Background: Type 2 Diabetes Mellitus (T2DM) is associated with cognitive decline, potentially mediated by neuroinflammatory processes and altered neuroplasticity. This study investigated cerebrospinal fluid (CSF) biomarkers of neuroinflammation and neuroplasticity in T2DM individuals versus controls, and their relationship with cognitive performance. Methods: This cross-sectional study included 56 T2DM individuals and 26 controls (aged 37–70 years; 48% male). CSF concentrations of leptin, IL-6, VEGF, BDNF, TNF-α, IGF-1, and IL-1β were measured using ELISA. Cognitive function was assessed using MMSE, the Stroop test, SDMT, RCFT, and TAAV. Group comparisons used Mann–Whitney U or t-tests; Spearman correlations examined variable relationships. Results: No statistically significant differences in CSF biomarkers were observed between groups. However, T2DM patients showed lower word recall (4.66 ± 1.48 vs. 5.81 ± 1.52; p = 0.002), reduced Symbol–Digit performance (17.82 ± 12.16 vs. 24.92 ± 12.10; p = 0.016), and higher Complex Figure Test scores (19.94 ± 9.32 vs. 15.94 ± 5.02; p = 0.009). IL-6 was negatively correlated with MMSE (r = −0.33, p = 0.005). Significant correlations emerged between MMSE and Symbol–Digit scores (r = 0.40, p < 0.001) and among biomarkers. Conclusions: “No statistically significant differences in CSF biomarkers were observed between groups and unadjusted CSF biomarker concentrations did not differ significantly between groups; however, after adjustment for age and BMI, IL-6 was significantly elevated in T2DM patients, indicating that covariate-adjusted analyses may be more sensitive for detecting subtle neuroinflammatory differences in this population. Full article
(This article belongs to the Section Diagnosis, Screening and Monitoring of Diabetes)
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19 pages, 1498 KB  
Review
Clinical Utility of Genetic Testing in Obesity: A Case-Based Review in the Context of Type 2 Diabetes
by Ahmed W. Al-Humadi, Claire H. Parker, Marcela Rodríguez-Flores, Daniah A. Alwash and Charis Liapi
Diabetology 2026, 7(8), 147; https://doi.org/10.3390/diabetology7080147 - 6 Aug 2026
Viewed by 342
Abstract
Background: Obesity has a significant genetic component, accounting for up to an estimated 70% of individual susceptibility. Advances in genome-wide association studies (GWASs) and next-generation sequencing (NGS) have enhanced identification and characterization of genetic forms of obesity, facilitating more precise and individualized treatment [...] Read more.
Background: Obesity has a significant genetic component, accounting for up to an estimated 70% of individual susceptibility. Advances in genome-wide association studies (GWASs) and next-generation sequencing (NGS) have enhanced identification and characterization of genetic forms of obesity, facilitating more precise and individualized treatment approaches. The phenotypic heterogenicity of the disease of obesity, along with the limited predictive value of clinical features, hinders the accurate identification of genetic forms of the disease. Therefore, genetic testing represents a critical diagnostic modality to confirm etiology and inform precision-based therapeutic strategies. Aim: To compare the clinical utility, interpretation and potential impact of direct-to-consumer (DTC-GT) and clinician-directed genetic testing for obesity in the context of type 2 diabetes. Methods: This case-based review evaluated a patient with severe obesity and type 2 diabetes who underwent both DTC-GT and clinician-directed genetic testing for obesity. A structured literature review using PubMed, Scopus, Web of Science, and Google was undertaken to identify the resources of both testing approaches. Tables and a schematic figure were developed to summarize the findings. Results: Neither testing approach identified clinically actionable obesity-associated genetic variants or a monogenic cause of obesity. However, the DTC-GT report concluded that the patient was at “high risk” of obesity and was provided to the patient without a referral to genetic counseling which contributed to patient misunderstanding. Conclusions: This case, interpreted alongside the reviewed literature, suggests that clinician-directed genetic testing may better support reliable interpretation of obesity-associated genetic findings and disease management than DTC-GT. Larger studies are warranted to confirm these observations. Full article
(This article belongs to the Section Diagnosis, Screening and Monitoring of Diabetes)
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15 pages, 480 KB  
Article
Fecal Short-Chain Fatty Acid Profiling in Type 2 Diabetes Mellitus Using GC–MS: A Comparative Study in a South African Population
by Scelo Khumalo, Zamathombeni Duma, Lizette Bekker, Puleng Matatiele, Lesibana Sethoga and Sara Mosima Pheeha
Diabetology 2026, 7(8), 142; https://doi.org/10.3390/diabetology7080142 - 23 Jul 2026
Viewed by 432
Abstract
Background: Type 2 diabetes mellitus (T2DM) is associated with altered gut microbiota and reduced short-chain fatty acid production, which may contribute to insulin resistance. However, evidence on fecal Short Chain Fatty Acid (SCFA) profiles in African populations remains limited. This study quantified fecal [...] Read more.
Background: Type 2 diabetes mellitus (T2DM) is associated with altered gut microbiota and reduced short-chain fatty acid production, which may contribute to insulin resistance. However, evidence on fecal Short Chain Fatty Acid (SCFA) profiles in African populations remains limited. This study quantified fecal SCFAs in individuals with and without T2DM using Gas Chromatography–Mass Spectrophotometry (GC-MS) with N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA) derivatization. Methods: A cross-sectional study included 140 adults (92 non-diabetic and 48 T2DM). Fecal SCFAs were extracted, derivatized using BSTFA, and analysed by GC–MS. Associations between SCFAs, diabetes status, and HbA1c were evaluated using non-parametric statistics. Results: The GC–MS method demonstrated strong linearity (R2 = 0.9917–0.9978), acceptable recovery, and reproducibility. Acetic, propionic, butyric, pentanoic, hexanoic, and heptanoic acids were detected, with acetic acid being most abundant in both groups. T2DM participants had higher median SCFA levels, although only butyric acid differed significantly (p = 0.027). HbA1c was significantly higher in the T2DM group (p < 0.001). No significant associations were observed between SCFAs and HbA1c in either group. Age differed significantly between groups, with T2DM participants older than non-diabetic controls. Conclusions: Most fecal SCFA profiles were comparable between individuals with T2DM and healthy controls. However, butyric acid was significantly elevated in the T2DM group, indicating that not all SCFAs exhibited similar patterns between the study groups. These findings suggest that fecal SCFAs alone may not serve as reliable biomarkers of T2DM in this population and highlight the influence of complex host–microbiome–environment interactions suggesting that dietary and microbial factors may outweigh disease status in determining SCFA variability in this cohort setting. Full article
(This article belongs to the Section Diagnosis, Screening and Monitoring of Diabetes)
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