Sort by
Serum metabolomics signature of maternally inherited diabetes and deafness by gas chromatography-time of flight mass spectrometry.

The aim of this study was to identify a metabolic signature of MIDD as compared to healthy controls and other types of diabetes. We performed a comprehensive serum metabolomic analysis using gas chromatography-time of flight mass spectrometry (GC-TOFMS) in participants diagnosed with MIDD (n = 14), latent autoimmune diabetes in adults (LADA) (n = 14), type 2 diabetes mellitus (n = 14), and healthy controls (n = 14). Each group was matched for gender and age. There were significant metabolic differences among MIDD and other diabetic and control groups. Compared with control, MIDD patients had high levels of carbohydrates (glucose, galactose, mannose, sorbose, and maltose), fatty acids (2-Hydroxybutyric acid, eicosapentaenoic acid, and octadecanoic acid), and other metabolites (alanine, threonic acid, cholesterol, lactic acid, and gluconic acid), but low level of threonine. Compared with LADA, MIDD patients had high levels of threonic acid and some amino acids (alanine, tryptophan, histidine, proline, glutamine, and creatine) but low levels of serine. Compared with type 2 diabetes mellitus, MIDD patients had high levels of citrulline, creatine, 3-Amino-2-piperidone, but low levels of ornithine, fatty acids (arachidonic acid and octadecanoic acid), and intermediates of the tricarboxylic acid cycle (malic acid and succinic acid). Our study identified a specific metabolic profile related to glycolysis and the tricarboxylic acid cycle in MIDD that differs from healthy controls and other types of diabetes. This unique metabolic signature provides new perspectives for understanding the pathophysiology and underlying mechanisms of MIDD.

Open Access Just Published
Relevant
The benefits and accuracy of real-time continuous glucose monitoring in children and adolescents with type 1 diabetes attending a summer camp.

This study evaluated the usability, satisfaction, and accuracy of a real-time continuous glucose monitoring (rt-CGM) in children and adolescents with type 1 diabetes (T1D) attending a summer camp. Seven children and adolescents with T1D (camper) and 31 of healthcare providers (HCPs) participating in a 2-day summer camp in Kumamoto, Japan were enrolled. The usability and satisfaction were evaluated by tailored questionnaire. The accuracy of rt-CGM was evaluated using self-monitoring of blood glucose (BG) and sensor glucose (SG) values before or after (off camp) and during (on camp) the camp. The score of the usefulness of rt-CGM showed 3.29 ± 0.90 in campers and 4.23 ± 0.87 in HCPs (P = 0.017). The degree of recommendation score for rt-CGM was 3.29 ± 1.11 in campers and 4.23 ± 0.79 in HCPs (P = 0.013). Time in range (TIR) off camp was 45.9% and that on camp was 57.0%. Time above range (TAR) off camp was 53.4% and that on camp was 42.4%. The mean absolute relative difference (MARD) off camp was 19.7% ± 25.2%, whereas that on camp was 16.0% ± 14.8% (P = 0.367). Clinically acceptable zones of the error grid analyses were approximately 96% in total. Rt-CGM exhibited higher usability and recommendation scores in HCPs than those in campers. This may be related to relatively lower accuracy in rt-CGM. Overall usability and recommendation are clinically satisfactory, but due to relatively low accuracy, no decision should be made based on a single, non-verified SG value alone.

Open Access Just Published
Relevant
Retrospective database study on risk factors for diabetic retinopathy and diabetic kidney disease in Japanese patients with diabetes mellitus.

This study aimed to investigate the risk factors for diabetic retinopathy (DR) and diabetic kidney disease (DKD) in Japanese patients with diabetes mellitus (DM). Identifying these factors could provide insights into the shared and distinct mechanisms contributing to these complications in the diabetic population. We conducted a retrospective analysis using the J-DREAMS (Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System) database, which is directly linked to electronic medical records. The study included Japanese people aged 18 years and older with diabetes, who were registered at a referral center between December 1, 2015, and March 31, 2021, and had simultaneous measurements of serum creatinine and hemoglobin A1c (HbA1c). The presence or absence of DR and DKD was determined for 8,794 and 8,770 patients, respectively. Multivariable logistic regression analyses were used to identify risk factors, considering patient characteristics, comorbid conditions, and laboratory data as explanatory variables. Common risk factors for both DR and DKD included hypertension, anemia, diabetic neuropathy, cerebrovascular disease, chronic heart failure, low serum albumin levels, and elevated HbA1c. The contributions of age, duration of DM, and body mass index (BMI) differed between the DR and DKD groups. In addition to poor glycemic control and hypertension, anemia, low serum albumin, cerebrovascular disease, and heart failure were identified as independent common risk factors for DR and DKD, suggesting the existence of cardio-renal anemia syndrome in patients with DM.

Open Access Just Published
Relevant
Mechanical loading-induced alveolar bone remodeling is suppressed in the diabetic state via the impairment of the specificity protein 1/vascular endothelial growth factor (SP1/VEGF) axis.

Orthodontic treatment involves alveolar bone remodeling in response to mechanical loading, resulting in tooth movement through traction-side bone formation and compression-side bone resorption. However, there are conflicting reports regarding alveolar bone resorption during the orthodontic treatment of patients with diabetes. Diabetes was induced in 8-week-old C56BL/6J mice using streptozotocin (STZ). Four weeks after the injection of STZ, a mechanical load was applied between the first and second molars on the right side of the upper jaw using the Waldo method with orthodontic elastics in diabetic (DM) and normal (N) mice tooth movement, gene expression, osteoclast counts, alveolar bone residual volume, and bone beam structure were evaluated. The duration until spontaneous elastic loss was significantly longer in the DM group, suggesting that tooth movement may be inhibited in the diabetic state. The number of osteoclasts at 7 days after mechanical loading and the alveolar bone resorption were both significantly lower in the DM group. The gene expression levels of vascular endothelial growth factor (VEGF), a protein related to alveolar bone remodeling, and specificity protein 1 (SP1), a transcription factor of the VEGF gene, were significantly lower in the DM group than in the N group on the compression side of mechanical loading. Mechanical loading-induced alveolar bone remodeling is suppressed in the diabetic state. Our results suggest that VEGF is a key molecule involved in impaired bone remodeling under mechanical loading in the diabetic state.

Open Access Just Published
Relevant
Association between malnutrition and adverse renal outcomes in patients with type 2 diabetes.

Nutritional management is crucial in patients with chronic kidney disease. Therefore, it is important to assess nutritional status and detect malnutrition, especially in patients with diabetes. However, there is currently a lack of evidence regarding the relationship between nutritional indices and renal function in patients with type 2 diabetes. This study investigated whether the geriatric nutritional risk index (GNRI) is related to renal prognosis in type 2 diabetes patients. The study included 946 type 2 diabetes patients enrolled in the Fukushima Cohort Study. The primary endpoint of this study was a renal event, defined as a combination of a 50% decline in eGFR from baseline and end-stage kidney disease. All-cause death and new cardiovascular events were also measured as secondary outcomes. The association between GNRI and these endpoints was assessed using Cox regression analysis. The median patient age was 66 years, 57% were men, the median eGFR was 67.9 mL/min/1.73 m2, and the median GNRI was 100.0. Compared to patients in the highest GNRI tertile, patients in the lowest tertile had a significantly increased risk of therenal event (HR 5.15, 95% CI 2.51-10.6) and all-cause death (HR 2.30, 95% CI 1.20-4.42). A significant association was not observed between GNRI levels and cardiovascular events. We observed an association between poor nutritional status, assessed by GNRI, and adverse outcomes in patients with type 2 diabetes. Nutritional status assessment has potential utility as a prognostic tool for individuals with type 2 diabetes.

Open Access Just Published
Relevant
Association of impaired fasting glucose with cardiometabolic multimorbidity: TheKailuan study.

We investigated the association between impaired fasting glucose (IFG) and cardiometabolic multimorbidity (CMM) in the Chinese population. We included 119,368 participants, free of diabetes mellitus and cardiovascular disease, who participated in the health examination (2006, 2008, 2010) of the Kailuan Study. According to World Health Organization diagnostic criteria, participants were divided into normal fasting blood glucose (FBG) (<6.1 mmol/L) and IFG (FBG 6.1-6.9 mmol/L) groups. CMM was defined as having two or more cardiometabolic diseases, including myocardial infarction, stroke and diabetes mellitus. We used Cox proportional hazards models to evaluate associations between IFG and CMM. During a median follow-up period of 13.94 years, 2,432 CMM incident events occurred. After adjusting potential confounders, the hazard ratio (HR) and 95% confidence interval (CI) for CMM in the IFG group was 2.83 (95% CI 2.58-3.10) versus the normal FBG group. The HR of IFG for diabetes mellitus was 3.43 (95% CI 3.30-3.55), which was >1.25 (95% CI 1.13-1.37) for myocardial infarction, 1.16 (95% CI 1.07-1.25) for ischemic stroke and 1.06 (95% CI 0.88-1.27) for hemorrhagic stroke. Compared with normal FBG, HRs for risk of IFG for CMM were 2.73 (95% CI 2.48-3.02) in men and 3.86 (95% CI 2.92-5.09) in women. IFG was a risk factor for CMM. The effect of IFG on diabetes mellitus was stronger than that on other cardiometabolic diseases. The effects of IFG for CMM differed by sex.

Open Access Just Published
Relevant