Search Results (199)

Background/Objectives: After diagnosis, it is common for women with breast cancer to gain weight, which is associated with worse clinical outcomes. However, traditional measures such as body weight, BMI, and waist circumference do not detect key changes in body composition, such as fat redistribution or muscle loss. The objective of this exploratory study was to assess the evolution of body composition and muscle strength after one year of treatment, and their relationship with metabolic biomarkers. Methods: Prospective observational study in newly diagnosed breast cancer patients. Body composition was assessed using bioelectrical impedance analysis (BIA) and ultrasound (US); muscle strength was measured by handgrip dynamometry. Biomarkers analyzed included glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), glycosylated hemoglobin (HbA1c), total cholesterol (and its fractions), triglycerides, C-reactive protein (CRP), 6-interleukin (IL-6), vitamin D, myostatin, and fibroblast growth factor 21 (FGF-21). Results: Sixty-one women (mean age 58 years) were included. After one year, fat mass and related parameters significantly increased, while skeletal muscle mass and muscle strength decreased. Sarcopenic obesity prevalence rose from 1.16% to 4.9%. No significant changes were found in biomarkers, but positive correlations were observed between fat parameters and insulin, HOMA-IR, and triglycerides, and negative correlations with HDL-cholesterol. Conclusions: BIA and US can detect unfavorable changes in body composition that are not reflected in conventional measurements. At one year post-diagnosis, women showed increased fat accumulation, muscle loss, and reduced strength, even without significant metabolic biomarker changes. Further research is warranted to elucidate the long-term clinical implications of these findings and the external validity in larger cohorts. Full article

Background: Type 2 diabetes (T2D) and overweight or obesity are strongly associated, with a high prevalence of these concomitant conditions contributing significantly to global healthcare costs. Given this burden, there is an urgent need for effective interventions. Mobile health (mHealth) technologies represent a promising strategy to address both conditions simultaneously. Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness of mHealth-based interventions for the management of adults with T2D and overweight/obesity. Specifically, it assessed the quantitative impact of these interventions on glycosylated hemoglobin (HbA1c), body weight, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels. Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus databases from inception to 9 July 2025. The inclusion criteria focused on randomized controlled trials (RCTs) using mHealth interventions in adults with T2D and overweight/obesity, reporting HbA1c or weight as primary or secondary outcomes. The risk of bias was assessed using the Cochrane Risk of Bias tool 2. A total of 13 RCTs met the inclusion criteria. Results: Meta-analysis indicated significant improvements after 6–12 months of intervention in HbA1c (MD −0.23; 95% CI −0.36 to −0.10; p < 0.001; I² = 72%), body weight (MD −2.47 kg; 95% CI −3.69 to −1.24; p < 0.001; I² = 79%), total cholesterol (MD −0.23; 95% CI −0.39 to −0.07; p = 0.004; I² = 0%), and LDL (MD −0.27; 95% CI −0.42 to −0.12; p < 0.001; I² = 0%). Conclusions: mHealth interventions are effective and scalable for managing T2D and obesity, particularly when incorporating wearable technologies to improve adherence. Future research should focus on optimizing personalization, engagement strategies, and long-term implementation. Full article

Background/Objectives: Diabetes mellitus is associated with significant health complications, including challenges in periodontal health. Gingival inflammation is especially common among diabetic patients and can significantly impact overall diabetes management. This study aims to investigate the correlation between glycosylated hemoglobin (HbA1c) levels, an established marker of glycemic control, and gingival inflammation using the Quantitative Gingival Bleeding Index (QGBI) among hospitalized diabetic patients, thereby placing the question within a broader clinical context. Methods: The study enrolled 671 hospitalized patients with diabetes complications at “Mother Theresa University Hospital” in Tirana, AL, USA. Glycemic control was assessed through glycosylated hemoglobin (HbA1c) levels, and gingival health was evaluated using the Quantitative Gingival Bleeding Index (QGBI). Behavioral variables were also documented, including smoking habits and routine oral care practices. Spearman’s correlation coefficient (r_s) was applied to determine the relationship between HbA1c levels and QGBI scores. Results: Our findings revealed a strong positive correlation between glycemic control (HbA1c) and gingival inflammation (QGBI) among the participants (Spearman’s coefficient r_s = 0.868, p < 0.001). Additionally, significant positive associations were observed between behavioral factors, such as smoking habits and regular oral care practices, further underscoring their role in periodontal health in diabetic patients. Conclusions: The study highlights a significant positive relationship between poor glycemic control and increased gingival inflammation, emphasizing the importance of periodontal health in the comprehensive management of diabetes mellitus. Our results support integrating periodontal evaluation and management into standard diabetes care, which could improve patient outcomes and overall well-being. Full article

Background: SGLT2 inhibitors (SGLT-2i) and GLP1 receptor agonists (GLP-1 RA) are recommended as the first line therapy for the management of type 2 diabetes mellitus (T2DM), particularly in patients with chronic kidney disease (CKD), cardiovascular disease (CVD), and heart failure (HF). Despite their established efficacy, there is limited evidence available to predict which subset of patients will respond favorably to them. We conducted this study to identify baseline characteristics to predict the response to therapy with SGLT-2i and GLP-1 RA. Methods: A retrospective analysis of the medical records was conducted at the Veteran Affairs Medical Center (VAMC) in Omaha, Nebraska, USA. Veterans who had completed 6–12 months of treatment with SGLT-2i or GLP-1 RA were included. Favorable treatment outcomes were a ≥0.5% reduction in glycosylated hemoglobin (HbA1c) or a ≥5% reduction in body weight; and those who achieved both outcomes were classified as adequate responders. Results: Patients in the GLP-1 RA group had 2.11 (95% CI: 1.45, 3.07) times the odds of achieving an adequate response as compared to patients in the SGLT-2i group in the unadjusted analysis, p < 0.001. HbA1c > 8% and older age was significantly associated with achieving an adequate response. Conclusions: Treatment with GLP-1 RA should be considered in Veterans with these characteristics. Full article

Background/Objectives: Diabetes mellitus has physical, psychological and behavioral implications related to glycemic control and quality of life. Our aims were to evaluate glycemic control and disease-related quality of life among adults with type 1 diabetes mellitus and to study their relationships with sociodemographic, clinical and anthropometric characteristics. Methods: Eighty-five participants (49.4% females, mean age 36 years, mean BMI 25.3 kg/m²) attending endocrinology and/or nutrition consultations at ULS São João (Porto, Portugal) were assessed regarding quality of life (Diabetes Health Profile) and social desirability (Marlowe–Crowne’s scale). Anthropometric (weight and height), biochemical (A1c) and metabolic control data (time at glycemic target) were collected, as well as information on type and duration of insulin therapy, carbohydrate counting, use of mobile applications for carbohydrate counting and perceived health status. Results: Older patients had higher BMI (r = 0.227, p = 0.037) and worse quality of life in the ‘barriers to activity’ domain (r = 0.290, p = 0.007). In the multivariate analysis, sociodemographic, clinical and quality of life characteristics significantly explained A1c (p = 0.046, η²_p = 0.271) and perceived health status (p = 0.012, η²_p = 0.313). Higher eating self-efficacy significantly explained better perceived health status (p = 0.006, η²_p = 0.105), but no variable independently had a significant effect on glycemic control. Conclusions: Glycemic control results from the interaction between various clinical features that must be considered in personalized approaches. Eating self-efficacy significantly explained perceived health status, and may represent a potential target for intervention among people with type 1 diabetes mellitus. Full article

Background/Objectives: Obesity is a major risk factor for diabetes mellitus, a metabolic disease characterized by elevated fasting blood glucose and glycosylated hemoglobin levels. Predicting the percentage and absolute variations in key medical parameters based on weight changes can help patients stay motivated to lose weight and assist doctors in making informed lifestyle and treatment recommendations. This study aims to assess the extent to which weight variation influences the absolute and percentage changes in various clinical parameters. Methods: The dataset includes medical records from patients in Bucharest hospitals, collected between 2012 and 2016. Several machine learning models, namely linear regression, polynomial regression, Gradient Boosting, and Extreme Gradient Boosting, were employed to predict changes in medical parameters as a function of body weight variation. Model performance was evaluated using Mean Squared Error, Mean Absolute Error, and R² score. Results: Almost all models demonstrated promising predictive performance. Quantitative predictions were made for each parameter, highlighting the relationship between weight loss and improvements in clinical indicators. Conclusions: Weight loss led to significant improvements in dysglycemia, dyslipidemia, inflammation, uric acid levels, liver enzymes, thyroid hormones, and blood pressure, with reductions ranging from 5% to 30%, depending on the parameter. Full article

Insulin resistance is more common in the elderly, and with the improvement in people’s living standards and changes in lifestyle habits, the incidence of insulin resistance in other age groups is also increasing year by year. Overweight and obesity caused by abnormal fat metabolism or accumulation can significantly reduce glucose intake, which is the direct cause of insulin resistance and the trigger for the occurrence and development of type II diabetes. This article reviews and analyzes relevant literature on empirical research on the effect of regular exercise on improving insulin resistance. It was found that the most important step in carbohydrate metabolism is the translocation of glucose transporter 4 (GLUT4) to the cell membrane, carrying water-soluble glucose through the lipid soluble cell membrane to complete carbohydrate transport. The process of glucose transporter protein translocation to the cell membrane can be driven by two different signaling pathways: one is the insulin information transfer pathway (ITP), the second is to induce the ITP of monophosphate-activated protein kinase (AMPK) through hypoxia or muscle contraction. For type II diabetes patients, the insulin signal transmission pathway through insulin receptors (IRS₁, IRS₂) and phosphatidylinositol 3-kinase (PI3K) (PI3K) is damaged, which results in the decrease in glucose absorption stimulated by insulin in skeletal muscle, while the noninsulin signal transmission pathway of AMPK in these patients is normal. It can be seen that regular exercise can regulate glucose intake and the metabolism of skeletal muscle, improve insulin resistance, reduce fasting blood glucose and glycosylated hemoglobin in diabetes patients, and thus, effectively regulate blood glucose. However, many steps in the molecular mechanism of how exercise training improves systemic insulin resistance are still not fully understood, and further discussion is needed in the future. Full article

Background/Aims: Diabetes mellitus is a major cause of atherosclerotic cardiovascular disease (ASCVD). We examined a large population and tested the efficacy of a voluntary lifestyle program in prediabetic and diabetic subjects. Methods: Of 133,764 subjects, 56.3% were healthy, 36.2% were prediabetic, and 7.5% were diabetic. Fasting serum measurements of glucose, insulin, adiponectin, glycosylated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), glycated serum protein (GSP), fibrinogen, myeloperoxidase (MPO), lipoprotein-associated phospholipase A₂ (LpPLA₂), as well as standard lipids, direct low-density lipoprotein cholesterol (LDL-C), and small dense LDL-C (sdLDL-C) were performed using standard automated assays. Follow-up sampling at 6–12 months occurred in 20.1% of the prediabetic and 22.2% of the diabetic subjects; of these, 12.2% of the prediabetic and 9.7% of the diabetic subjects participated in a voluntary, real-world, digital dietitian-directed lifestyle-modification program with a 10-year diabetes risk being calculated using a biochemical model (Framingham). Results: Prediabetic and diabetic subjects had significantly elevated triglycerides, sdLDL-C, and hs-CRP and decreased HDL-C. They were insulin resistant as compared to healthy subjects, but only diabetics had significant reductions in insulin production. Lifestyle modification significantly reduced diabetes risk by 45.6% in prediabetics and significantly increased (2.4-fold) the percentage of diabetics that were in remission at follow-up (8.2% versus 3.4%) with increased weight loss (6.5 versus 2.0 pounds). Lifestyle intervention resulted in significant favorable effects on many metabolic markers. Conclusions: The measurement of fasting glucose and insulin is essential for the detection of decreased insulin production in diabetics. A digital lifestyle program can have favorable effects on ASCVD risk factors and diabetic status. Full article

Background: Diabetic kidney disease (DKD), a severe chronic complication of diabetes, significantly impacts the quality of life and life expectancy of affected individuals. Meanwhile, advanced glycation end products (AGEs) are believed to play a central role in the pathogenesis of DKD. Skin autofluorescence (SAF) is a well-validated, noninvasive technique for the estimation of AGE levels in the dermis. Aims: This study aims to evaluate the correlation between SAF and DKD prevalence, as well as the association between SAF and renal function parameters, in patients with Type 2 Diabetes Mellitus (T2DM). Methods: This cross-sectional analysis included 1259 hospitalized T2DM patients. SAF was measured using a spectroscopy device. Logistic regression analysis, p-trend analysis, and restricted cubic spline were performed with the prevalence of DKD as the dependent variable. Multiple linear regression analyses were conducted to investigate the associations of SAF with renal function parameters, specifically the estimated glomerular filtration rate (eGFR) and the log-transformed albumin-to-creatinine ratio (ln(ACR)). Results: The prevalence of DKD was strongly associated with SAF rather than with glycosylated hemoglobin (HbA1c). For each arbitrary unit (AU) increase in SAF, DKD incidence rose by 1.6%. A significant stepwise increase in the odds ratio (OR) of DKD was observed across SAF quartiles. A dose-response relationship existed between SAF and the OR value of DKD. Additionally, SAF showed a linear correlation with eGFR and ln(UACR). For each AU increase in SAF, eGFR decreased by 0.14 mL/min/1.73 m², while UACR increased by 1.2%. Conclusions: Elevated SAF, rather than HbA1c, is independently associated with increased DKD prevalence and impaired renal function. Full article

Diabetes mellitus is a chronic, degenerative, and multifactorial disease characterized by hyperglycemia, and at least 537 million people suffered from diabetes in 2021. Agave durangensis Gentry, a species of agave native to the state of Durango, reports phenolic compounds, flavonols, flavonoids, and saponins and could be an alternative for the treatment of diabetes. The aim of this work was to identify the compounds in the leaves of Agave durangensis Gentry and their potential activity in diabetes. The leaf extract of Agave durangensis Gentry (EAD) was characterized by ultra-performance liquid chromatography–mass spectrometry (UPLC-MS), and different families of bioactive compounds were quantified by analytical methods. Probable pharmacological targets were identified in silico, and the inhibition of dipeptidyl peptidase-4 (DPP4) was validated in vitro. A model of hyperglycemia was established with streptozotocin in male Wistar rats, and we administered EAD intragastrically at a dose of 300 mg/kg, as well as combinations of the extract with metformin and sitagliptin over 30 days. Biochemical and histological parameters were analyzed. We identified thirty-six major compounds, where triterpenes represented 30% of the extract. Molecular docking showed that the extract could interact with α-glucosidases and DPP4 since a large number of compounds in the extract have a Δ G lower than that reported for the controls, and DPP4 inhibition was confirmed by in vitro assays. In vivo assays demonstrated that the administration of the extract was able to significantly decrease glucose levels by 56.75% and glycosylated hemoglobin by 52.28%, which is higher than that reported for sitagliptin with a decrease of 35.22%. In addition, the extract decreased triglycerides by 59.28% and very-low-density lipoprotein (VLDL) cholesterol by 60.27%, and when administered in combination with metformin, it decreased them more than when metformin was administered alone. For all the above reasons, Agave durangensis Gentry extract could be used for the development of phytomedicine for the treatment of diabetes. Full article

Background/Objectives: No previous study has provided a comprehensive evaluation of all biventricular and biatrial myocardial strain parameters in women with previous gestational diabetes mellitus (pGDM). Accordingly, we aimed at investigating the structural and myocardial deformation properties of all cardiac chambers in a cohort of pGDM women at 4 years postpartum. Methods: A consecutive cohort of pGDM women was compared to a control group of healthy women with previous uncomplicated pregnancy, matched by age, ethnicity and gestational week, at 4 years postpartum. Both groups of women underwent transthoracic echocardiography (TTE) implemented with speckle-tracking echocardiography (STE) and subsequent carotid ultrasonography. The primary endpoint was subclinical myocardial dysfunction, defined as left-ventricular (LV) global longitudinal strain (GLS) < 20%, whereas the secondary endpoint was early carotid atherosclerosis, defined as common carotid artery (CCA) intima-media thickness (IMT) ≥ 0.7 mm. Results: A total of 32 pGDM women (39.1 ± 6.5 yrs) and 30 matched healthy controls (40.8 ± 5.0 yrs) were analyzed. Despite normal and similar systolic function on conventional TTE, all biventricular and biatrial strain parameters were significantly lower in pGDM women than controls. Mean follow-up period was 4.0 ± 1.9 yrs. During follow-up, 62.5% of pGDM women developed subclinical myocardial dysfunction, and 78.1% of them were diagnosed with early carotid atherosclerosis. Third-trimester BMI (OR 1.88, 95% CI 1.19–2.98) and third-trimester glycosylated hemoglobin (HbA1C) (OR 2.34, 95% CI 1.08–5.04) were independently associated with the primary endpoint. Third-trimester BMI and HbA1C also independently predicted the secondary endpoint. Third-trimester BMI > 27 kg/m² and HbA1C > 33 mmol/mol showed the best sensitivity and specificity for predicting both endpoints. Conclusions: Women with a previous history of GDM complicated by overweight/obesity and uncontrolled diabetes have a significantly increased risk of subclinical myocardial dysfunction and early carotid atherosclerosis at 4 years postpartum. Full article

Metabolic syndrome, a cluster of metabolic disorders comprising dyslipidemia, insulin resistance, elevated blood pressure, and abdominal obesity, is a silent epidemic that may lead to outcomes such as cardiovascular disease, diabetes, and cancer. Due to the increase in the prevalence of these pathologies, the search for better treatments and more efficient drugs is imperative. Species of Artemisia and Salvia genera are excellent examples of noteworthy sources of bioactive products with health applications, their therapeutic properties being well known both in popular medicine and in the scientific community. There are reports of plant extracts or compounds from species belonging to either of these genera, which were able to combat cancer, diabetes, and cardiovascular pathologies. For instance, dihydroartemisinin (analog of artemisin extracted from Artemisia annua L.) can reduce tumor markers p53 and Ki-67 expression levels, leading to a reduction in tumor proliferation. Salvia officinalis L. has antihyperglycemic and lipid profile-improving effects since it decreases total cholesterol, glycosylated hemoglobin, fasting glucose, low-density lipoprotein cholesterol, and triglyceride levels while increasing high-density lipoprotein cholesterol levels. Clinical trials using mixtures (dried powdered plants or extracts) of known medicinal plants are recurrent in published works, in contrast with the scarce clinical trial studies with isolated compounds. Salvia miltiorrhiza Bunge. was by far the most targeted plant in the clinical trials analyzed here. Regarding clinical trials concerning Artemisia, there are more studies aiming to see its effect on diabetes, but the studies about cancer are more advanced. This review aims to give a critical summary of the most interesting and promising results from clinical trials. The abundance of studies with limited statistically significant clinical evidence hinders progress in clinical therapy. This situation demands far greater rigor from the scientific community, researchers, regulatory agencies, editors, and reviewers in conducting and publishing clinical studies. Full article

Background/Objectives: Diabetes prevalence is high among Arab populations, where cultural practices present barriers to effective glycemic control. Despite guidelines recommending the involvement of dietitians in diabetes management, evidence of the effectiveness of dietitian-involved interventions in these populations remains limited. This systematic review and meta-analysis evaluated the effectiveness of dietitian-involved lifestyle interventions among Arab populations with prediabetes or diabetes. Methods: PubMed, CINAHL, and the Cochrane Library were systematically searched for studies employing experimental and quasi-experimental designs with interventions involving dietitians. All reported outcomes were considered to ensure a comprehensive review. The protocol was registered in PROSPERO (registration number CRD42024555668). Results: The meta-analysis showed significant reductions in glycosylated hemoglobin (HbA1c) levels (−0.41; 95% CI: −0.67, −0.16), body mass index (BMI) (−0.28; 95% CI: −0.36, −0.19), and increases in high-density lipoprotein cholesterol HDL-C) (0.60; 95% CI: 0.36, 0.85) compared to usual care. Subgroup analysis indicated variations based on follow-up duration. The certainty of the evidence was low due to heterogeneity and potential biases, emphasizing the need for further high-quality research to confirm these findings. Conclusions: Interventions involving dietitians improve glycemic control and metabolic outcomes among Arab populations. Given the unique cultural challenges in this population, culturally tailored and personalized interventions are essential to overcome barriers and improve diabetes-related outcomes. Future studies should focus on expanding the evidence base, integrating these findings into healthcare policies, and exploring strategies for long-term sustainability and broader application. Full article

To investigate the dietary effects of chlorogenic acid (CGA) on the growth performance, lipid metabolism, antioxidant activity, and non-specific immunity of Asian swamp eel (Monopterus albus) during the domestication stage, a 28-day feeding experiment was conducted to supplement with CGA at levels of 0 (Cont.), 250 (CGA 0.50%), 500 (CGA 1.00%), and 750 (CGA 1.50%) mg/kg·bw by feeding with yellow mealworm (Tenebrio molitor). Compared with the control group, the addition of 250–750 mg/kg of CGA significantly increased the weight-gain rate (WG) of M. albus, and the CGA 1.0% group displayed the highest value. The content of hemoglobin and high-density lipoprotein in all CGA groups was markedly elevated (p < 0.05), while the triglyceride, glucose, low-density lipoprotein, and glycosylated serum protein levels were lowered (p < 0.05). Among the antioxidant enzymes, the glutathione peroxidase and catalase activity was significantly higher in all experimental groups than that of the control group, whereas the malondialdehyde activity was significantly reduced (p < 0.05). For a non-specific immune enzyme system, the lysozyme and alkaline phosphatase activity in all treatments and the superoxide dismutase and acid phosphatase activity in the CGA 0.5% group was markedly increased (p < 0.05). In conclusion, supplementation with CGA can enhance the growth performance and improve the lipid metabolism, antioxidant capacity, and non-specific immunity of M. albus during the domestication stage, and the optimal CGA supplementation for T. molitor as biocarrier bait is 500 mg/kg, corresponding to 405 mg/kg. Full article

This study compared glycosylated hemoglobin (HbA1c) levels in the first and second trimesters of pregnancy and assessed maternal and neonatal outcomes according to HbA1c variations among women with pregestational diabetes. This retrospective, multicenter Korean study involved mothers with diabetes who had given birth in 17 hospitals. A total of 292 women were divided into three groups based on HbA1c levels during the first and second trimesters: women with HbA1c levels maintained at <6.5% (well-controlled [WC] group); women with HbA1c ≥ 6.5% (poorly-controlled [PC] group); and women with HbA1c ≥ 6.5% in the first trimester but <6.5% in the second trimester (improved-control [IC] group). The PC group had the highest pregnancy-associated hypertension (PAH) incidence, while the incidence did not significantly differ between the WC and IC groups. The receiver operating characteristic (ROC) curve indicated that HbA1c in the second trimester could predict PAH with a cut-off value of 5.7%. The PC versus WC versus IC group showed statistically significantly higher neonatal birthweight and significantly higher rates of large for gestational age (LGA); however, those were not significantly different between the WC and IC groups. HbA1c levels in the second trimester could predict LGA, with a cut-off value of 5.4%. Therefore, the second trimester HbA1c levels were significantly associated with both maternal and neonatal outcomes. Full article