Search Results (15,591)

Down syndrome (DS), caused by trisomy 21, is associated with a wide spectrum of endocrine and gastrointestinal disorders that often arise early in life and significantly impact long-term health. This narrative review examines the pathophysiological mechanisms underlying these conditions, with a particular focus on their bidirectional interactions. Endocrine abnormalities in DS, including thyroid dysfunction, type 1 diabetes mellitus, growth impairment, and altered bone metabolism, occur at higher rates than in the general population and are largely driven by immune dysregulation, chronic inflammation, and gene dosage effects. Similarly, gastrointestinal disorders—ranging from congenital malformations to autoimmune conditions such as celiac disease—are highly prevalent and often present with atypical clinical features. Emerging evidence highlights the central role of gut dysbiosis, characterized by reduced microbial diversity and increased pro-inflammatory taxa, in modulating immune and metabolic pathways. This altered gut environment contributes to a chronic inflammatory state and may promote autoimmunity and endocrine dysfunction through the gut–endocrine–immune axis. Nutritional deficiencies and epigenetic factors, including microRNA dysregulation, further influence disease expression. Understanding this complex cross-talk is essential for improving clinical management. Integrated, multidisciplinary approaches and early screening strategies are crucial to optimize outcomes and guide future research in DS. Full article

Background: Type 1 diabetes mellitus (T1D) is associated with chronic inflammation, platelet-related alterations, and increased cardiovascular risk (CVR). The relationships between adipokines and platelet indices in long-standing T1D remain incompletely defined. Objective: To explore the relationships between adipokines (adiponectin and leptin), platelet indices, and inflammatory status in adults with long-standing T1D. Methods: This cross-sectional study included 124 adults with long-standing T1D and 59 non-diabetic controls. Platelet indices were obtained from automated blood count, and serum leptin (LEP), adiponectin (ADNC), and C-reactive protein (CRP) were measured using standardized assays. Associations were evaluated using correlation and multivariable regression analyses with adjustment for body mass index (BMI). Results: Platelet count (PLT) and plateletcrit (PCT) were higher in T1D compared with non-diabetic individuals (p = 0.003 for both), while mean platelet volume (MPV) and platelet distribution width (PDW) showed non-significant upward trends. ADNC levels were higher in T1D (p < 0.001), whereas LEP and the leptin–adiponectin ratio (LAR) did not differ between groups. In T1D, LEP correlated with PLT (rho = 0.235), PCT (rho = 0.263), and CRP (rho = 0.474), all p < 0.05. Similar associations were observed for LAR. No significant associations were found in non-diabetic controls. In multivariable analyses, PCT remained associated with LEP in T1D after adjustment for BMI, whereas in the control group, LEP was associated with BMI only. Conclusions: LEP and platelet-related indices were associated in individuals with long-standing T1D, whereas ADNC showed no such relationships. These findings suggest a distinct pattern of adipokine–platelet associations in long-standing T1D. Full article

Regular consumption of excess sugar is linked to nutrition-based diseases, including gut problems, Non-Alcoholic Fatty Liver Disease, and Type 2 Diabetes Mellitus. Increasing sweetness perception is a novel technique to decrease sugar consumption. This experiment compared the sweetness perception of sweetened and unsweetened almond milk in response to different virtual environments with music and visuals. Two music types, the classical song Goldberg Variations, BMV. 998-Variation 13 and a jazz song generated by AI were used. Additionally, fall and spring forest backgrounds were generated by the Blockade Labs 3D image generator. Each participant tasted sweetened and unsweetened almond milk in music-only, background-only, and combination music and background environments. Results revealed significant differences in sweetness ratings for music type (p = 0.015) and between milk types (p < 0.001). Viscosity rating differed significantly between backgrounds (p = 0.04) and by milk type (p < 0.001). Liking ratings varied significantly between backgrounds (p < 0.001) and between music genres (p = 0.011). The results suggest that altering music and background may be a strategy to change sweetness and viscosity perception in unsweetened beverages. Full article

Background: Post-COVID syndrome represents a significant medical and public health challenge, particularly among older adults and individuals with type 2 diabetes mellitus (T2DM), in whom disturbances in immune and metabolic homeostasis may contribute to the development and persistence of symptoms following SARS-CoV-2 infection. Objective: To investigate the clinical, immunological, and metabolic characteristics of post-COVID syndrome in older adults with T2DM. Methods: A cross-sectional comparative study was conducted involving 141 patients aged ≥ 60 years who were evaluated more than one year after SARS-CoV-2 infection. Clinical data, anthropometric measurements, complete blood count parameters, biochemical markers, glycated hemoglobin (HbA1c), and SARS-CoV-2-specific IgG antibodies were assessed. Statistical analyses were performed using nonparametric methods, while Pearson’s χ² test was applied for categorical variables. A p-value < 0.05 was considered statistically significant. Results: Symptoms consistent with post-COVID syndrome one year after SARS-CoV-2 infection were identified in 53.2% of participants. No significant differences in anthropometric characteristics, hematological parameters, or most biochemical markers were observed between patients with and without post-COVID syndrome. Patients with T2DM exhibited higher fasting glucose, HbA1c, and SARS-CoV-2–specific IgG antibody levels, reflecting underlying metabolic characteristics and differences in humoral immune responses during the late post-COVID period. Conclusions: Post-COVID syndrome symptoms were frequently observed among older adults at the time of assessment, more than one year after SARS-CoV-2 infection, despite normalization of most laboratory parameters. In patients with T2DM, higher glucose, HbA1c, and antibody levels likely reflect underlying metabolic characteristics rather than a direct effect of post-COVID syndrome. Further longitudinal studies are warranted to clarify the long-term clinical significance of the observed metabolic and immunological findings. Full article

This paper analyzes the role of cereal products in the diet of individuals with disorders of carbohydrate metabolism, with particular emphasis on their impact on postprandial glycemia and the risk of developing type 2 diabetes (T2D). Cereal products, as the main source of dietary carbohydrates, also provide dietary fiber, minerals, B vitamins, and key bioactive compounds such as β-glucans, arabinoxylans, resistant starch (RS), and polyphenols. These components may reduce the rate of starch digestion and glucose absorption in the small intestine by increasing the viscosity of intestinal contents or by directly inhibiting digestive enzymes such as α-glucosidase. It has been shown that fermentation of these compounds by the gut microbiota leads to the production of short-chain fatty acids (SCFAs), which improve insulin sensitivity and stimulate the secretion of incretin hormones such as GLP-1. A literature review confirms that regular consumption of whole-grain products is associated with a reduced risk of T2D, whereas refining processes and excessive grain fragmentation lead to an increased glycemic index of products. Based on clinical guidelines and a narrative synthesis of the available literature, minimally processed whole-grain products were identified as a fundamental component of dietary therapy for diabetes, which is illustrated by the cereal product pyramid presented in the paper. This review involved a comprehensive literature search in PubMed, Scopus, and Web of Science using relevant keywords. Peer-reviewed articles, reviews, and meta-analyses (mainly 2000–2025) were included based on their relevance. Full article

Background/Objectives: Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia, dyslipidemia, and oxidative stress, leading to severe systemic complications. Medicinal plants rich in polyphenolic compounds have gained increasing attention as complementary therapeutic agents. This study aimed to comparatively evaluate the chemical composition, as well as the antidiabetic, hypolipidemic, and antioxidant effects of Polygonum persicaria and Vaccinium myrtillus in a streptozotocin-induced diabetic model. Although Vaccinium myrtillus has been more extensively investigated for its antidiabetic potential, the pharmacological relevance of Polygonum persicaria in diabetes remains insufficiently characterized, particularly in direct comparison with a recognized phytotherapeutic comparator. Methods: Hydroalcoholic tinctures prepared from Polygonum persicaria L. herb and Vaccinium myrtillus L. leaves were subjected to phytochemical analysis using High-Performance Thin-Layer Chromatography (HPTLC) for the identification of flavonoids and phenolcarboxylic acids, alongside spectrophotometric determination of total polyphenol and flavonoid content. Experimental diabetes was induced in CD1 mice by streptozotocin administration. Animals were treated orally for 35 days, and glycemic parameters, lipid profile, body weight, food and water intake, and oxidative stress markers (MDA, SOD, TAC, and GPx) were evaluated. Results: HPTLC/CSS screening indicated the presence of rutin, chlorogenic acid, and caffeic acid in Polygonum persicaria, while Vaccinium myrtillus showed stronger densitometric signals for phenolcarboxylic acid-type compounds, particularly chlorogenic and caffeic acids. Total polyphenol and flavonoid content were also higher in Vaccinium myrtillus (433.89 ± 8.67 mg/L GAE; 154.38 ± 3.08 mg/L QE) compared to Polygonum persicaria (269.28 ± 5.25 mg/L GAE; 132.75 ± 2.65 mg/L QE). Functionally, Vaccinium myrtillus demonstrated a significant antihyperglycemic effect from day 14 (p = 0.009) and improved lipid parameters, while Polygonum persicaria showed a delayed glycemic effect, significant only at day 35 (p = 0.014), without significant hypolipidemic activity. In contrast, Polygonum persicaria exerted a marked antioxidant effect, significantly increasing GPx activity (p = 0.025) and reducing MDA levels (p = 0.053). Conclusions: Vaccinium myrtillus showed stronger antihyperglycemic and hypolipidemic effects, while Polygonum persicaria was mainly associated with antioxidant-related biochemical changes. These differences may be influenced by phytochemical composition, but they cannot be attributed solely to total polyphenol or flavonoid content. Full article

Background/Objectives: The increasing burden of non-communicable diseases, together with accelerating environmental degradation, highlights the urgent need for sustainable dietary patterns that promote both human and planetary health. The Mediterranean diet (MedDiet), traditionally followed in countries bordering the Mediterranean basin, has gained recognition as a model of sustainable nutrition due to its well-documented health benefits and relatively low environmental impact. However, its broader role within sustainable food systems requires comprehensive and interdisciplinary evaluation. The aim of this review is to provide a state-of-the-art synthesis of the evidence on the MedDiet as a sustainable dietary pattern, integrating its health, environmental, economic, and socio-cultural dimensions. Methods: This state-of-the-art narrative review synthesizes evidence from peer-reviewed literature on the MedDiet and sustainability. Relevant studies were identified through major scientific databases, focusing on publications addressing nutritional, environmental, economic, and socio-cultural dimensions. Both observational and interventional studies, as well as modeling and life cycle assessment analyses, were included. Additional sources from international organizations and policy reports were incorporated to contextualize global trends and challenges. Results: High adherence to the MedDiet is consistently associated with a reduced risk of cardiovascular disease, type 2 diabetes, cancer, and all-cause mortality. From an environmental perspective, the MedDiet is associated with lower greenhouse gas emissions, reduced land and water use, and enhanced biodiversity conservation compared with Western dietary patterns. Economically, it may represent a cost-effective dietary model and support local food systems when grounded in traditional practices, although affordability varies across contexts. Socio-culturally, the MedDiet promotes food heritage, culinary skills, and social cohesion. Nevertheless, globalization, urbanization, and the increasing consumption of ultra-processed foods have contributed to declining adherence, posing significant challenges to its sustainability and scalability. Moreover, the sustainability benefits of the MedDiet seem to be context-dependent rather than intrinsic, raising several challenges and limitations for its adoption. Conclusions: The MedDiet should be viewed not as a definitive solution to global food-system challenges but as a valuable reference model that illustrates how dietary practices can contribute simultaneously to human health, environmental sustainability, and cultural continuity. Modern sustainable dietary strategies should build upon the strengths of the MedDiet while recognizing its limitations, embracing contextual adaptation, and addressing the structural determinants that shape food choices. Full article

Background and Objectives: Type 2 diabetes mellitus (T2DM) causes retinal microvascular changes that precede clinically apparent diabetic retinopathy (DR). We aimed to identify which optical coherence tomography angiography (OCTA) biomarkers best distinguish eyes with T2DM without clinical DR from healthy controls and to evaluate machine learning classifiers trained on a comprehensive 68-parameter OCTA panel. Materials and Methods: In this prospective case–control study, 80 patients with T2DM without clinical DR and 33 controls underwent 3 × 3 mm macular OCTA using an Optovue RTVue Avanti System. After outlier screening, 221 eyes (155 T2DM, 66 controls) were analyzed. Sixty-eight OCTA parameters were extracted, covering FAZ morphometry (including foveal density FD-300), SCP and DCP vessel density and layer thickness, outer-retina and choriocapillaris flow, and a full retinal-thickness map. Between-group comparisons used the Mann–Whitney U test with Benjamini–Hochberg FDR correction. Logistic regression, random forest, and XGBoost classifiers were evaluated with patient-grouped 10-fold cross-validation; feature importance was quantified via SHAP. Results: Forty-two of 68 parameters reached FDR significance (q < 0.05). Deep capillary plexus vessel density was the most discriminative family (whole image rb = −0.66, q = 2.5 × 10⁻¹³; parafovea rb = −0.64). FD-300 was reduced in T2DM (median 47.55% vs. 51.86%; rb = −0.57; q = 1.0 × 10⁻¹⁰) and emerged as the top SHAP feature (mean |SHAP| = 0.81). FAZ circularity decreased without FAZ-area enlargement, and outer-retina flow was paradoxically elevated (rb = +0.39), consistent with a projection artifact. XGBoost using all 68 features achieved a patient-grouped cross-validated AUC of approximately 0.91, compared with 0.85 for conventional SCP + DCP whole-image density. No parameter correlated with current HbA1c in T2DM (all q > 0.98), and the well-controlled (<7%) and poorly controlled (≥7%) subgroups were indistinguishable across five of six principal biomarkers, consistent with metabolic memory. FD-300 remained independent after adjustment for hypertension, hyperlipidemia, and age (OR = 0.76; 95% CI 0.69–0.84; p < 0.001). Conclusions: A multi-compartment OCTA panel outperforms conventional two-layer vessel-density metrics in detecting preclinical diabetic microvasculopathy, although external validation is required before clinical use. FD-300 is the single most informative biomarker, while choriocapillaris and retinal thickness measures provide complementary, compartment-specific signals. Because the OCTA signature is decoupled from the current HbA1c, screening should not be deferred in well-controlled T2DM. Full article

Type 1 Diabetes (T1D) is a complex autoimmune disorder characterized by immune-mediated destruction of pancreatic β cells, driven by genetic susceptibility and modulated by environmental factors, notably the gut microbiome. Dysbiosis, manifested as reduced microbial diversity, perturbations in the Firmicutes/Bacteroidetes ratio, and compromised short-chain fatty acid production, contributes to T1D pathogenesis through mechanisms involving immune system dysregulation and heightened intestinal permeability. Emerging evidence indicates a relationship between the gut and oral microbiomes, as well as the potential influence of the virome and mycobiome. This narrative review synthesizes the current literature on the intricate interplay between the gut microbial ecosystem, the host immune response, and the development of T1D, highlighting the potential for targeted microbiome-based interventions to ameliorate disease progression. A more nuanced understanding of these multi-kingdom interactions is essential for developing precise therapeutic strategies to prevent or delay T1D onset and to improve patient outcomes through restoration of immune tolerance and gut homeostasis. Full article

Background/Objectives: Pulmonary complications and respiratory muscle weakness are common in individuals with type 2 diabetes mellitus (Type 2 DM). Physical inactivity may further contribute to impaired respiratory muscle performance and reduced cough effectiveness in this population. The aim of this study was to examine the relationship between physical activity level, respiratory muscle strength, and cough strength in individuals with Type 2 DM. This study was an observational cross-sectional study. Methods: Thirty individuals with Type 2 DM and thirty age- and sex-matched healthy controls were included. Their physical activity level was assessed using the International Physical Activity Questionnaire (IPAQ), and respiratory muscle strength was evaluated using maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), whereas cough strength was assessed using a peak expiratory flow meter. Group comparisons were performed using the Mann–Whitney U test, and associations were analyzed using Spearman’s correlation coefficients. Additional multivariable regression analyses were conducted after adjustment for body mass index (BMI) and waist circumference. Results: Physical activity level, respiratory muscle strength, and cough strength were significantly lower in individuals with Type 2 DM than in healthy controls (p < 0.05). Within the Type 2 DM group, IPAQ scores were positively correlated with MIP (r = 0.438, p = 0.016), MEP (r = 0.581, p = 0.001), and cough strength (r = 0.619, p < 0.001), and diabetes duration was negatively correlated with MIP (r = −0.412, p = 0.024). After adjustment for BMI and waist circumference, Type 2 DM status remained independently associated with lower MIP (B = −15.69, 95% CI: −26.58 to −4.80, p = 0.006) and lower cough strength (B = −90.51, 95% CI: −161.52 to −19.50, p = 0.013). Conclusions: Individuals with Type 2 DM demonstrated lower physical activity levels, respiratory muscle strength, and cough strength than healthy controls. Higher physical activity levels were associated with better respiratory muscle strength and cough strength, whereas longer diabetes duration was associated with lower inspiratory muscle strength. These findings suggest that respiratory muscle function and cough performance may be adversely affected in individuals with Type 2 DM, warranting further investigation in larger longitudinal studies. Full article

Background: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a serious complication associated with substantial morbidity and healthcare costs. Although two-stage revision arthroplasty is widely accepted as a standard treatment, debridement, antibiotics, and implant retention (DAIR) is frequently attempted as a less invasive initial strategy. However, the impact of failed DAIR on the outcomes of subsequent two-stage revision remains controversial. Methods: This retrospective cohort study included patients who underwent two-stage revision arthroplasty for PJI following TKA at a single institution between 2005 and 2019, involving 84 knees at an average follow-up of 5.1 ± 3.3 years. Outcomes were compared between patients with a history of failed DAIR (F-DAIR group, n = 23) and those who underwent direct two-stage revision without prior procedures (DTSR group, n = 61). Treatment failure rates and associated risk factors were analyzed. Results: There was no significant difference in treatment failure rates between the F-DAIR and DTSR groups (4.3% vs. 9.8%, respectively; p = 0.668). Cox regression suggested that PJI type (acute vs. chronic) and diabetes mellitus were associated with treatment failure. Conclusions: In this retrospective cohort, prior failed DAIR was not associated with a statistically significant reduction in the success of subsequent two-stage revision arthroplasty. These findings may support consideration of DAIR as an initial treatment option in carefully selected patients; however, cautious interpretation is warranted because of the retrospective design, limited sample size, baseline imbalance, and small number of failure events. Therefore, the findings should be considered hypothesis-generating rather than definitive comparative evidence. Full article

Background/Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of bisphosphonate therapy, whose risk is currently assessed through qualitative staging systems that do not integrate pharmacological determinants of cumulative drug exposure. The aim of this study is to present the Bisphosphonate Accumulation Index (BAI), a pharmacologically derived, dimensionless scalar quantifying cumulative exposure to bone-targeted antiresorptive agents by integrating relative potency, administered dose, dosing frequency, route-specific bioavailability, and treatment duration, for use as a pre-procedural assessment tool in patients receiving bisphosphonates. Methods: The BAI combines five pharmacologically grounded parameters from peer-reviewed literature: (1) relative antiresorptive potency referenced to etidronate; (2) dose per administration (mg); (3) monthly dosing frequency; (4) bioavailability route; and (5) years of treatment within the preceding 10-year window. The model includes nine bisphosphonates registered in Italy. Results: The BAI spans approximately five orders of magnitude (from <1000 for short-term oral therapy to >120,000 for monthly intravenous zoledronic acid). Four analyses support the model: sensitivity analysis identifies relative potency as the main source of variance; ecological calibration against nine MRONJ incidence data points yielded r = 0.911 (p = 0.0006, R² = 0.829), indicating that the BAI accounts for approximately 83% of the population-level variance in published incidence rates across heterogeneous regimens (ecological correlation; this does not establish individual-level predictive validity); Monte Carlo simulation on 10,000 patients generated a plausible exposure-strata distribution (6.1% low, 66.6% moderate, 27.3% high); and concordance analysis with a DDD-based metric showed discordance in 7/8 regimens. Conclusions: The BAI is a transparent, reproducible, pharmacologically grounded metric of cumulative antiresorptive exposure addressing the quantitative gap identified in the AAOMS 2022 Position Paper. The BAI measures pharmacological exposure, which is a necessary but insufficient component of MRONJ risk; clinical modifiers such as corticosteroid co-administration, diabetes, renal function, and procedure type are not integrated and must be evaluated independently. The provisional exposure strata reported here (<1000, 1000–10,000, >10,000) are hypothesis-generating and intended solely to guide the design of validation studies; they should not be used as clinical decision rules until prospective patient-level validation has been completed. Full article

Background: Diabetic peripheral neuropathy (DPN) is a progressive complication of type 2 diabetes mellitus (T2DM) for which no approved disease-modifying therapy exists. Palmitoylethanolamide/Baicalin (PEA/Bai; Neuridase^®) is a nutraceutical formulation with anti-neuroinflammatory and antioxidant properties; however, real-world evidence on its associations with objective neuropathy biomarkers remains limited; nutraceutical approaches to DPN remain exploratory and adjunctive in the absence of randomised controlled trial evidence of disease modification. Methods: We conducted a single-centre, retrospective, 1:1 matched-cohort study at an Internal Medicine outpatient clinic. Forty-eight T2DM patients with clinically diagnosed DPN who received PEA/Bai supplementation (Neuridase^® group) were matched to 48 untreated controls drawn from a large institutional database, using age, sex, BMI, and diabetes duration as matching variables. Acknowledged a priori limitations include baseline imbalance in neuropathy severity (VAS and ESC) and SGLT2 inhibitor use, reflecting real-world prescribing patterns (confounding by indication) and constituting potential sources of residual confounding that preclude causal inference. The primary outcome was change in VAS neuropathic pain score from baseline (T0) to 6-month follow-up (T6). Secondary outcomes were changes in electrochemical skin conductance (ESC, µS) in hands, feet, and four-limb sum measured by Sudoscan. Results: At baseline, the Neuridase^® group exhibited significantly greater neuropathic burden: higher VAS scores (median 5.5 [IQR 3.8–7.2] vs. 2.0 [0.0–5.0]; p < 0.001) and lower ESC in both hands (53.0 vs. 72.2 µS; p < 0.001) and feet (74.5 vs. 81.0 µS; p < 0.001), reflecting real-world prescribing patterns. Over 6 months, VAS decreased significantly in the Neuridase^® group (5.5→3.0; p < 0.0001; median Δ = −2.5 points, exceeding the clinically important difference), with no change in controls (2.0→2.0; p = 0.85). Differential Sudoscan trajectories were observed: the Neuridase^® group showed significant improvement in hand ESC (53.0→60.0 µS; p = 0.035) and preservation of foot ESC (p = 0.888), while controls exhibited significant deterioration across all three sudomotor indices (hand p = 0.038; foot p = 0.008; four-limb sum p = 0.004). In a complementary categorical pain trajectory analysis, VAS worsening occurred in 31.3% of controls compared with 0% of Neuridase^®-treated patients (p = 0.00022). Among patients with pathological hand ESC at baseline (<60 µS), 27.8% of Neuridase^® patients (n = 36) transitioned to non-pathological values at T6 versus 0% of controls (n = 32; p = 0.001). Conclusions: In a real-world matched cohort, PEA/Baicalin supplementation was associated with clinically meaningful pain reduction and with differential longitudinal sudomotor trajectories compared to matched untreated controls. These exploratory, hypothesis-generating findings from a retrospective non-randomised design are consistent with possible modulatory effects of PEA/Baicalin on objective sudomotor autonomic biomarkers in DPN. Confounding by indication, baseline severity imbalance, and residual confounders including SGLT2 inhibitor use preclude causal interpretation. These observations provide a rationale for adequately powered, prospective, randomised placebo-controlled trials with extended follow-up and structural neuropathy endpoints. Full article

Dendrobium huoshanense water extract (DHWE) exhibits hypoglycemic effects in streptozotocin-induced type 1 diabetic (STZ-T1D) rats. However, its regulatory impact on the gut microbiota of T1D rats remains largely unclear. In this study, metagenomic sequencing was employed to characterize alterations in the gut microbiota of STZ-T1D rats following DHWE intervention, aiming to explore associations between DHWE-mediated gut microbial changes and T1D-related phenotypes. The results showed that 1300 mg/kg·BW/day DHWE did not significantly affect gut microbial α-diversity (p > 0.05), but drove the β-diversity structure toward that of normal rats. Meanwhile, DHWE significantly reduced the Bacteroidota/Bacillota ratio (p < 0.05), Megamonas (p < 0.01), Megamonas funiformis (p < 0.01), and notably increased the relative abundances of Adlercreutzia (p < 0.01), Adlercreutzia equolifaciens (p < 0.01) in STZ-T1D rats. Furthermore, functional annotation revealed that DHWE enriched multiple metabolic pathways, including streptomycin biosynthesis, ansamycins biosynthesis, galactose metabolism, ether lipid metabolism, and caprolactam degradation. Collectively, these findings demonstrate that DHWE reshapes gut microbiota composition and function in STZ-T1D rats, offering new clues regarding how gut microbial changes may contribute to the modulatory effects of Dendrobium huoshanense in T1D conditions. Full article

Type 2 diabetes mellitus (T2DM) is a major global health burden characterized by insulin resistance, progressive pancreatic β-cell dysfunction, and chronic metabolic dysregulation. Marine seaweeds have emerged as a valuable source of bioactive natural products, particularly polyphenols and polysaccharides, with promising potential for diabetes management. This review focuses on three major contributions: first, the structural diversity of seaweed-derived polyphenols and polysaccharides; second, their multi-target mechanisms of glucose regulation; and third, the structure–activity relationships governing their bioactivities. Current evidence shows that these compounds may help manage type 2 diabetes in several ways, including inhibition of α-amylase and α-glucosidase, attenuation of oxidative stress and chronic inflammation, enhancement of insulin secretion and insulin sensitivity, regulation of lipid metabolism, and modulation of gut microbiota. Key structural determinants such as degree of polymerization, hydroxyl group density, sulfation level, molecular weight, and chemical modifications are discussed in relation to their functional properties. By linking chemical structure with biological function, these findings highlight marine seaweeds as a rich reservoir of multi-target therapeutic candidates for T2DM management and provide a scientific basis for their development as functional food ingredients or lead compounds for novel diabetes management drugs. Full article