Search Results (104)

Background/Objectives: Low vitamin D levels are associated with an elevated risk of Alzheimer’s disease (AD). Given the rising prevalence of diabetes and its association with AD, this study investigated whether vitamin D modulates amyloidogenesis and inflammation in the brains of diabetic mice. Methods: Five-week-old male C57BLKS/J-m+/m+(con) and C57BLKS/J-db/db (db) mice received diets with low or high vitamin D (LVD or HVD) for 8 weeks. Hippocampal neuronal morphology was assessed using H&E and Nissl staining, and Aβ levels, along with the mRNA expression of genes related to amyloidogenesis, amyloid degradation, inflammation, antioxidation, and neurotrophic factors, were measured in the hippocampus and prefrontal cortex (PFC). Results: High dietary vitamin D levels attenuated neuronal necrosis in db/db mice. Hippocampal App and Bace1 expression levels were higher in db/db mice; however, amyloidogenic gene (App, Bace1, Ps1) expression levels in both the hippocampus and PFC were significantly lower in db_HVD group compared with those in db_LVD group (all p < 0.05). Among control mice, PFC App and Ps1 expression levels were lower in con_HVD group than in con_LVD group. Nonetheless, Aβ42 protein levels were not affected by either diabetes or dietary vitamin D levels. Furthermore, lower hippocampal Iκbα and PFC Mcp-1 expression levels in db_HVD group than those in db_LVD group were observed, both upregulated in diabetic mice. Amyloid degradation-related gene or Vdr expression was not altered by dietary vitamin D levels. Conclusions: These findings suggest that vitamin D may exert neuroprotective effects on the hippocampus and PFC in diabetic mice by mitigating neuronal damage and suppressing amyloidogenic and inflammatory gene expression. Full article

Background/Objectives: Peer support offers a promising approach for improving psychosocial outcomes among adults with type 1 diabetes (T1D). However, research has focused largely on the recipients of peer support rather than the individuals who provide support. This pilot study investigates the impact of delivering support on diabetes distress and other secondary mental health outcomes (e.g., depressive symptoms, resilience, and perceived social support). Methods: This pre–post single-cohort study recruited 44 adults with T1D who underwent a six-hour Zoom-based peer supporter training program designed to equip them with support-related skills (asking open-ended questions, making reflections, expressing empathy). Of this group, 36 served as peer supporters for REACHOUT, a six-month mental health support intervention delivered via mobile app. Assessments were conducted at baseline and after six months and measured diabetes distress (Type 1 Diabetes Distress Scale), depressive symptomatology (Patient Health Questionnaire-8), resilience (Diabetes Strengths and Resilience Measure), and perceived social support. Unadjusted and adjusted linear mixed models were performed for each outcome measure of interest. Results: Peer supporters had a mean age of 41 ± 16 years, with a majority identifying as female (75%). At baseline, peer supporters had little to no diabetes distress (50%) and no to mild depressive symptomatology (72%). Mean scores at baseline for diabetes distress, depressive symptoms, resilience, and perceived social support were sustained at 6 months post-intervention. Conclusions: Among peer supporters whose diabetes distress scores start around the target range, ongoing maintenance of these levels may reflect a favorable outcome associated with delivering mental health support. Full article

Background/Objectives: Type 2 diabetes (T2D) is associated with elevated cardiovascular risk and mortality. While physical activity can reduce cardiovascular risk, sustaining behavioral change remains challenging. Wearable activity trackers offer a scalable approach to promote physical activity, but their effects on cardiovascular outcomes in adults with T2D have not been well studied. To evaluate the impact of a wrist-worn activity tracker on physical activity, cardiovascular markers, and metabolic outcomes in adults with T2D over four weeks. Methods: This pilot randomized controlled trial included eight adults with T2D (mean age 54.9 ± 12.6 years; intervention (FIT) group: n = 5; control (CON) group: n = 3). The intervention group received an activity tracker. Both groups used the Fitbit app to track daily activity. Physical activity metrics (steps, walking distance, energy expenditure) and cardiovascular markers (blood pressure, augmentation index, pulse wave velocity, subendocardial viability ratio [SEVR]) were assessed pre- and post-intervention. Non-parametric tests and Spearman correlations were used due to the small sample size. Results: The FIT group showed significant increases in walking distance and energy expenditure and reductions in systolic/diastolic blood pressure, pulse pressure, and mean arterial pressure (all p < 0.04). SEVR trended toward improvement (p = 0.07). No significant changes were seen in the CON group. Increased physical activity was strongly correlated with reductions in pulse pressure (ρ = −0.88) and fasting glucose (ρ = −0.82; both p < 0.05). Conclusions: A brief wearable-based intervention improved physical activity and cardiovascular markers in adults with T2D, supporting feasibility for diabetes care. Full article

This paper presents the design, development, and pilot deployment of Vitalia, an AR-gamified application targeting the formation of healthy habits in primary education children. Developed within the EU DUSE project, Vitalia integrates physical activity, nutritional education, and immersive storytelling into a gamified framework to promote sustained behavioral change. Grounded in evidence-based behavior change models and co-designed with health, nutrition, and physical activity experts, the system envisions high daily engagement rates and measurable knowledge improvements. The concept positions Vitalia as a scalable model for child-centric, ethically responsible digital health interventions, with the potential to be integrated into school curricula and public health strategies. Full article

Background/Objectives: Diabetes frequently leads to cognitive impairment, encompassing issues with memory and executive function, as well as depression and anxiety. This study examines the impact of high-intensity interval exercise (HIIE) alongside glucagon-like peptide-1 receptor agonist (GLP-1 RA) semaglutide on cognitive dysfunction associated with diabetes. Methods: Db/db mice were divided into a control group, semaglutide group, HIIE group, and semaglutide combined with HIIE group to study metabolic and neurobehavioral effects. Cognitive and behavioral tests, hippocampal morphology, and molecular analyses (APP, BDNF, Aβ, p-Tau, PKA, AMPK) were performed. HT22 cells under high glucose were treated with semaglutide, L-lactate, PKA inhibitor H89, and AMPK inhibitor Compound C to validate mechanisms. Results: Over 8 weeks, both HIIE and semaglutide improved neuronal morphology and cognitive performance while reducing depression in db/db mice. However, the current study observed no synergistic effects. Both therapies decreased Aβ and p-Tau protein levels and increased BDNF levels in the hippocampus, likely through the AMPK and PKA signaling pathways, respectively. In vitro, HT22 cells under high glucose conditions exhibited elevated APP and p-Tau expression and reduced BDNF levels, which could be altered by L-lactate and semaglutide. The AMPK inhibitor Compound C and the PKA inhibitor H89 attenuated the increase in BDNF levels induced by L-lactate and semaglutide, but their combination mitigated this inhibitory effect. This study suggests that while HIIE and semaglutide improve cognitive function and reduce depression via BDNF, their combined use did not show the anticipated synergistic benefits due to potential antagonism between the AMPK and PKA pathways. Conclusions: This has important implications for designing exercise prescriptions for cognitive impairment in diabetics. Full article

Background/Objectives: Mobile health (mHealth) apps have become a revolutionary tool in managing and treating chronic diseases, providing numerous advantages for both patients and healthcare providers. These apps leverage technology to offer a variety of functions that support the monitoring, management, and enhancement of a patient’s health. Methods: We performed an observational study with 147 participants, using a questionnaire to evaluate the impact of mHealth applications on lifestyle changes in individuals managing chronic health conditions, including diabetes, obesity, and hypertension. Results: The study found that 40% of participants used the app daily, with a further 24.39% using it weekly and 14.63% using it occasionally. The positive health impact of the app was evident, with improvements in key health metrics such as glucose levels (73.42%), weight (62.02%), and adherence to dietary recommendations (71.31%). Conslussions: These findings aligned with studies on the effectiveness of mHealth apps in managing chronic conditions like diabetes. These broad health improvements reported by users suggested that the app was effective in promoting healthier behaviors. The high levels of user satisfaction and engagement highlighted how effective the app was. All in all, our study found that mHealth apps are valuable tools for people managing chronic health conditions, helping to motivate users and improve their health. Full article

Background/Objectives: Diabetic encephalopathy (DE), a severe neurological complication of diabetes mellitus (DM), is characterized by cognitive dysfunction. 3-Methyladenine (3-MA), a methylated adenine derivative, acts as a biomarker for DNA methylation and exhibits hypoglycemic and neuroprotective properties. However, the pharmacological mechanisms underlying 3-MA’s therapeutic effects on diabetic microvascular complications remain incompletely understood, owing to the intricate and multifactorial pathogenesis of DE. Methods: This study employed network pharmacology and molecular docking techniques to predict potential targets and signaling pathways of 3-MA against DE, with subsequent validation through animal experiments to elucidate the molecular mechanisms of 3-MA in DE treatment. Results: Network pharmacological analysis identified two key targets of 3-MA in DE modulation: AKT and GSK3β. Molecular docking confirmed a strong binding affinity between 3-MA and AKT/GSK3β. In animal experiments, 3-MA significantly reduced blood glucose levels in diabetic mice, ameliorated learning and memory deficits, and preserved hippocampal neuronal integrity. Furthermore, we found that 3-MA inhibited apoptosis by regulating the expression of Bax and BCL-2. Notably, 3-MA also downregulated the expression of amyloid precursor protein (APP) and Tau while enhancing the expression of phosphorylated AKT and GSK-3β. Conclusions: Our findings may contribute to elucidating the therapeutic mechanisms of 3-MA in diabetic microangiopathy and provide potential therapeutic targets through activation of the AKT/GSK-3β pathway. Full article

The Alzheimer’s disease (AD)-affected brain is known to be deficient in the utilization of glucose, its main energy substrate, and systemic diabetes is a significant risk factor for AD. In the course of biochemical and molecular investigations into this puzzling relationship, it has been shown that resistance to insulin action is a prominent feature of early stages of AD in the brain, thereby contributing to an energy failure state and a decline in synaptic function. In one AD-like cellular model, we found that β-amyloid (Aβ) accumulation inhibited insulin signaling and cell viability through an alteration of the PI3K/PDK-1/Akt signal pathway, an effect overcome by mTORC2 stimulation. A PDK-1 allosteric agonist, PS48, as well as newly synthesized analogs, were also found to reverse the metabolic defects caused by intracellular Aβ42 accumulation. In vivo, we previously showed that oral dosing of PS48 significantly improves learning and memory in APP/PS1 transgenic mice. Herein, we present evidence using unbiased immunohistological quantification and Western blot analyses demonstrating that ingested PS48 crosses into brain tissue where it targeted Akt and GSK3-β activities. Beneficial effects on neuronal number and Tau phosphorylation were found. Not unexpectedly, Aβ levels remained unchanged. These results support a path toward a future therapeutic trial of this untested strategy and agent in humans. Full article

Background/Objectives: Smartphones, with their widespread popularity and diverse apps, have become essential in our daily lives, and ongoing advancements in information technology have unlocked their significant potential in healthcare. Our goal is to identify the future research directions of mobile health (mHealth) by examining its research trends and emerging hotspots. Methods: This study collected mHealth-related literature published between 2005 and 2024 from the Web of Science database. We conducted a descriptive statistic of the annual publication count and categorized the data by authors and institutions. In addition, we developed visualization maps to display the frequency of keyword co-occurrences. Furthermore, overlay visualizations were created to showcase the average publication year of specific keywords, helping to track the changing trends in mHealth research over time. Results: Between 2005 and 2024, a total of 6093 research papers related to mHealth were published. The data have revealed a rapid increase in the number of publications since 2011. However, it was found that research on mHealth has reached a saturation point since 2021. The University of California was the dominant force in mHealth research, with 248 articles. The University of California, the University of London, Harvard University, and Duke University are actively collaborating, which shows a geographical pattern of collaboration. From the analysis of keyword co-occurrence and timeline, the research focus has gradually shifted from solely mHealth technologies to exploring how new technologies, such as artificial intelligence (AI) in mobile apps, can actively intervene in patient conditions, including breast cancer, diabetes, and other chronic diseases. Privacy protection policies and transparency mechanisms have emerged as an active research focus in current mHealth development. Notably, cutting-edge technologies such as the Internet of Things (IoT), blockchain, and virtual reality (VR) are being increasingly integrated into mHealth systems. These technological convergences are likely to constitute key research priorities in the field, particularly in addressing security vulnerabilities while enhancing service scalability. Conclusions: Although the volume of core research in mobile health (mHealth) is gradually declining, its practical applications continue to expand across diverse domains, increasingly integrating with multiple emerging technologies. It is believed that mobile health still holds enormous potential. Full article

Aim: Mobile health (mHealth) applications have been reported to be effective in improving glycaemic control and cardiometabolic health, but mainly as part of shorter-term intervention studies. The aim of this study is to examine the effect of the ongoing Defeat Diabetes mHealth low-carbohydrate diet (LCD) intervention on clinical markers and cardiometabolic risk after 6 months of intervention. Methods: Data were collected via primary care physicians as part of routine T2D monitoring. These included HbA1c (primary outcome), blood pressure, blood lipids, and markers of kidney and liver function. Anthropometrics, as well as changes in the prescription of diabetes, hypertension, and dyslipidaemia medication, were also recorded. Calculated variables, total cholesterol to HDL-c, triglyceride to HDL-c, and waist to height ratios, were analysed to examine changes in cardiometabolic risk profile. Three-day food records were used to assess dietary intake and intervention adherence. Univariate regression models examined changes from baseline to 6 months. Results: Ninety-four participants remained in the study out of the ninety-nine at baseline (mean age 59 ± 11 years, 55 females). After 6 months of intervention, there were significant reductions in HbA1c by −1.0% (95% CI: −1.3 to −0.6), as well as in the liver enzymes ALT (−9.3 U/L 95% CI −16.3 to −2.4) and GGT (−18.8 U/L 95% CI: −31.4 to −6.3) across the cohort. In addition, there was a significant reduction in cardiometabolic risk, as measured by the calculated variables and a decrease in waist circumference (−4.6 cm 95% CI: −8.9 to −0.2). Conclusions: People with T2D receiving LCD education and resources through the Defeat Diabetes mHealth app (version 3.3.8) improved their glycaemic control after 6 months of intervention. Cardiometabolic risk profile and liver function also showed significant improvement. These findings indicate that the use of an LCD digital app is a valuable adjunct in the management of T2D. Full article

Adolescents with long-term health conditions may benefit from digital health interventions (DHIs) to support self-management. The study aimed to map the current research on DHIs for adolescents with long-term conditions in South Africa, focusing on the types of interventions, targeted chronic conditions, and reported outcomes. The scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. Searches were conducted in electronic databases such as EBSCOHost (CINAHL, MEDLINE, Academic Search Ultimate, and APA PSycArticles), Wiley Online Library, and PubMed for articles published between 2014 and 2024. Studies that (1) involved adolescents with a long-term health condition (aged 15–24) residing in South Africa, (2) reported on the use of digital health technology, and (3) provided empirical evidence were included. Nine studies were included in the analysis, focusing primarily on HIV, depression/anxiety, and diabetes. Most interventions utilized WhatsApp, SMS, or social media to provide peer or healthcare worker support. Process outcomes like acceptability and feasibility dominated, with limited data on effectiveness. DHIs show potential for supporting adolescent health but cover a limited number of long-term health conditions and face barriers to effective implementation. Affordable, context-specific solutions co-designed with adolescents are crucial to enhance engagement and ensure scalability in the South African context. Registration: The protocol was registered on Open Science Framework. Full article

Patient experience is a critical healthcare quality indicator, evolving from Patient Satisfaction (PS) and encompassing patients’ concrete healthcare experiences. It is increasingly vital in aging societies where collaborative efforts among patients, families, and healthcare professionals are essential. Studies suggest that enhanced patient experience leads to better adherence, outcomes, and patient safety. This paper reviews patient experience evaluations in older adults with diabetes through randomized controlled trial (RCT)-based findings. The author searched PubMed/MEDLINE, Embase, AMED, and CINAHL. The review focused on RCTs examining interventions affecting patient experience and PS in T2D/T1D patients aged ≥65. A total of 13 RCTs were eligible for this review. This review highlights studies on diabetes management in older adults, assessing the impact of health education, diabetes management programs, treatments, mHealth, and advanced insulin delivery systems. Early studies showed that education improved self-care but had a limited impact on glycemic control. Key findings include the effectiveness of experience-based education in improving HbA1c, the benefits of insulin therapy for elderly patients, and the value of structured peer-to-peer diabetes management programs in enhancing satisfaction. Patient adherence, satisfaction, and personalized support emerged as critical factors influencing diabetes management across various interventions. More recent trials involving mHealth demonstrated improvements in glycemic control and PS through automated data sharing and app-based support. Closed-loop insulin delivery studies reported reduced mental strain, improved glycemic control, and better quality of life, despite barriers such as device cost and occasional system limitations. These interventions highlight the potential of advanced technologies to enhance diabetes care, particularly for aging populations. Previous RCTs show that education, structured management programs, effective insulin therapies, and advanced digital treatments improve patient experience, though well-designed studies focusing on patient experience as a primary outcome are lacking. Developing patient experience assessment scales for aging diabetes patients and adapting healthcare systems to maximize patient experience amid digitalization trends are essential, warranting further research. Full article

Metabolic syndrome (MetS) is a complex of interrelated risk factors, associated with several serious chronic diseases like diabetes. The goal of this study was to find dietary factors of successful weight loss for MetS outpatients. We performed a 90-day dietary intervention in a telemedically supported, pre- and post-test, controlled trial in Hungary involving 132 MetS patients; 67 were in the intervention, and 65 were in the control group. Patients in the intervention group used wireless smart devices, a dietary logger, and a lifestyle app. During the trial, we recorded the patients’ weight loss and diet composition. For analysis, t-tests were used, and the temporal trends of diet composition in the intervention group were analyzed between two sub-groups according to weight loss success. Correlation and regression models were used to find predictors of success. The intervention group achieved more weight loss, and the success in this group was linked with more consumption of raw fruits/vegetables, poultry and potato dishes, while age had a negative effect. We conclude that telemedically supported dietary coaching is an efficient alternative for interventions directed at weight loss. Future trials should investigate the therapeutic application of diets rich in raw fruits, especially apples, and vegetables, as well as poultry dishes. Full article

Diabetes is a major risk factor for Alzheimer’s disease (AD). Amino acid compound 2 (AAC2) improves glycemic and cognitive functions in diabetic mouse models through mechanisms distinct from insulin. Our goal was to compare the effects of AAC2, insulin, and their nanofiber-forming combination on early asymptomatic AD pathogenesis in APP/PS1 mice. Insulin, but not AAC2 or the combination treatment (administered intraperitoneally every 48 h for 120 days), increased seizure-related mortality, altered the brain fat-to-lean mass ratio, and improved specific cognitive functions in APP/PS1 mice. NanoString and pathway analysis of cerebral gene expression revealed dysregulated synaptic mechanisms, with upregulation of Bdnf and downregulation of Slc1a6 in insulin-treated mice, correlating with insulin-induced seizures. In contrast, AAC2 promoted the expression of Syn2 and Syp synaptic genes, preserved brain composition, and improved survival. The combination of AAC2 and insulin counteracted free insulin’s effects. None of the treatments influenced canonical amyloidogenic pathways. This study highlights AAC2’s potential in regulating synaptic gene expression in AD and insulin-induced contexts related to seizure activity. Full article

Background/Objectives. Obesity, type 2 diabetes (T2D), and Alzheimer’s disease (AD) are pathologies that affect millions of people worldwide. They have no effective therapy and are difficult to prevent and control when they develop. It has been known for many years that these diseases have many pathogenic aspects in common. We highlight in this review that neuroglial cells (astroglia, oligodendroglia, and microglia) play a vital role in the origin, clinical–pathological development, and course of brain neurodegeneration. Moreover, we include the new results of a T2D-AD mouse model (APP+PS1 mice on a high-calorie diet) that we are investigating. Methods. Critical bibliographic revision and biochemical neuropathological study of neuroglia in a T2D-AD model. Results. T2D and AD are not only “connected” by producing complex pathologies in the same individual (obesity, T2D, and AD), but they also have many common pathogenic mechanisms. These include insulin resistance, hyperinsulinemia, hyperglycemia, oxidative stress, mitochondrial dysfunction, and inflammation (both peripheral and central—or neuroinflammation). Cognitive impairment and AD are the maximum exponents of brain neurodegeneration in these pathological processes. both due to the dysfunctions induced by metabolic changes in peripheral tissues and inadequate neurotoxic responses to changes in the brain. In this review, we first analyze the common pathogenic mechanisms of obesity, T2D, and AD (and/or cerebral vascular dementia) that induce transcendental changes and responses in neuroglia. The relationships between T2D and AD discussed mainly focus on neuroglial responses. Next, we present neuroglial changes within their neuropathological context in diverse scenarios: (a) aging involution and neurodegenerative disorders, (b) human obesity and diabetes and obesity/diabetes models, (c) human AD and in AD models, and (d) human AD-T2D and AD-T2D models. An important part of the data presented comes from our own studies on humans and experimental models over the past few years. In the T2D-AD section, we included the results of a T2D-AD mouse model (APP+PS1 mice on a high-calorie diet) that we investigated, which showed that neuroglial dysfunctions (astrocytosis and microgliosis) manifest before the appearance of amyloid neuropathology, and that the amyloid pathology is greater than that presented by mice fed a normal, non-high-caloric diet A broad review is finally included on pharmacological, cellular, genic, and non-pharmacological (especially diet and lifestyle) neuroglial-related treatments, as well as clinical trials in a comparative way between T2D and AD. These neuroglial treatments need to be included in the multimodal/integral treatments of T2D and AD to achieve greater therapeutic efficacy in many millions of patients. Conclusions. Neuroglial alterations (especially in astroglia and microglia, cornerstones of neuroinflammation) are markedly defining brain neurodegeneration in T2D and A, although there are some not significant differences between each of the studied pathologies. Neuroglial therapies are a very important and p. promising tool that are being developed to prevent and/or treat brain dysfunction in T2D-AD. The need for further research in two very different directions is evident: (a) characterization of the phenotypic changes of astrocytes and microglial cells in each region of the brain and in each phase of development of each isolated and associated pathology (single-cell studies are mandatory) to better understand the pathologies and define new therapeutic targets; (b) studying new therapeutic avenues to normalize the function of neuroglial cells (preventing neurotoxic responses and/or reversing them) in these pathologies, as well as the phenotypic characteristics in each moment of the course and place of the neurodegenerative process. Full article