Chronic Complications Of Diabetes Mellitus Research Articles

Application of three-dimensional speckle tracking technique in measuring left ventricular myocardial function in patients with diabetes

BACKGROUND Diabetic cardiomyopathy is considered as a chronic complication of diabetes mellitus (DM). Therefore, early detection of left ventricular systolic function (LVSF) damage in DM is essential. AIM To explore the use of the three-dimensional speckle tracking technique (3D-STI) for measuring LVSF in DM patients via meta-analysis. METHODS The electronic databases were retrieved from the initial accessible time to 29 April 2023. The current study involved 9 studies, including 970 subjects. We carried out this meta-analysis to estimate myocardial function in DM compared with controls according to myocardial strain attained by 3D-STI. RESULTS Night articles including 970 subjects were included. No significant difference was detected in the left ventricular ejection fraction between the control and the diabetic group (P > 0.05), while differences in global longitudinal strain, global circumferential strain, global radial strain, and global area strain were markedly different between the controls and DM patients (all P < 0.05). CONCLUSION The 3D-STI could be applied to accurately measure early LVSF damage in patients with DM.

A Review of Traditional Chinese Medicine Syndrome Research on Type 2 Diabetes Mellitus and Its Common Chronic Complications

Type 2 diabetes mellitus is the leading cause of diabetes complications in China, threatening people’s health and quality of life seriously. Over the past few years, with the change in lifestyle and dietary habits, the course of diabetes mellitus is gradually prolonged, and complications in diabetic patients are becoming increasingly common, so scholars have studied the syndrome associated with this disease, which has led to certain research findings. The purpose of this article is to summarise the research progress of diabetes mellitus, diabetic nephropathy, diabetic retinopathy, diabetes mellitus with heart disease, diabetic peripheral neuropathy, and other chronic complications of diabetes mellitus from two aspects of literature and clinical research, present directions and strategies for standardising syndrome types of diabetes mellitus and its common chronic complications.

HMOX1 as a therapeutic target associated with diabetic foot ulcers based on single-cell analysis and machine learning.

Diabetic foot ulcers (DFUs) are a serious chronic complication of diabetes mellitus and a leading cause of disability and death in diabetic patients. However, current treatments remain unsatisfactory. Although macrophages are associated with DFU, their exact role in this disease remains uncertain. This study sought to detect macrophage-related genes in DFU and identify possible therapeutic targets. Single-cell datasets (GSE223964) and RNA-seq datasets (GSM68183, GSE80178, GSE134431 and GSE147890) associated with DFU were retrieved from the gene expression omnibus (GEO) database for this study. Analysis of the provided single-cell data revealed the distribution of macrophage subpopulations in the DFU. Four independent RNA-seq datasets were merged into a single DFU cohort and further analysed using bioinformatics. This included differential expression (DEG) analysis, multiple machine learning algorithms to identify biomarkers and enrichment analysis. Finally, key results were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western bolt. Finally, the findings were validated using RT-qPCR and western blot. We obtained 802 macrophage-related genes in single-cell analysis. Differential expression analysis yielded 743 DEGs. Thirty-seven macrophage-associated DEGs were identified by cross-analysis of marker genes with macrophage-associated DEGs. Thirty-seven intersections were screened and cross-analysed using four machine learning algorithms. Finally, HMOX1 was identified as a potentially valuable biomarker. HMOX1 was significantly associated with biological pathways such as the insulin signalling pathway. The results showed that HMOX1 was significantly overexpressed in DFU samples. In conclusion, the analytical results of this study identified HMOX1 as a potentially valuable biomarker associated with macrophages in DFU. The results of our analysis improve our understanding of the mechanism of macrophage action in this disease and may be useful in developing targeted therapies for DFU.

Self-care of chronic illness prevents the risk of diabetic foot ulcers in patients with diabetes: a cross-sectional study

Introduction: Diabetic foot ulcer (DFU) is a serious and chronic complication of diabetes mellitus (DM). This study aims to explain a model of self-care of chronic illness on the prevention of DFU risk in patients with DM, including foot self-care of maintenance, monitoring, and management. Methods: This study was an analytical study with a cross-sectional approach, with 300 patients randomly selected from six Public Health Centers in Surabaya, Indonesia, from June to August 2022. The inclusion criteria were individuals with DM and aged more than 26 years. Exclusion criteria were reading disabilities or having cognitive impairments Data were collected using a questionnaire. The correlation between variables was analyzed using the statistical method  of Partial Least Squares. Results: The risk of DFU in patients with DM was 40% with low risk, 38% with moderate risk, 8% with high risk, 5% remission, and 10% with DFU. This research shows that there is a significant correlation between foot self-care management and the risk of DFU, where the p-value = 0.000, while the indicators of foot self-care maintenance and self-care monitoring do not have a significant correlation with the risk of DFU, where the p-value is respectively equal to 0.350 and 0.844. Conclusions: Foot self-care management was a factor that directly correlates with the risk of DFU. Autonomous self-care management behaviors still needed to be improved, because most patients still had these inadequate behaviors. Further research is needed to improve the behavior quality of patients with DM in managing foot care independently.

The effect of geraniol dressing obtained from rose oil wound healing in diabetic rats

Introduction: Diabetic foot is one of the most important chronic complications of diabetes mellitus. In this study, the aim was to investigate the healing effect of dressing with geraniol material obtained from rose oil. Materials and Methods: The experimental period of the study was carried out between June 2, 2016, and 27, 2016. Sprague-Dawley rats were used and three experimental, two control groups were formed. In the study conducted with a total of 40 rats, each group consisted of eight rats. Geraniol dressing, isotonic wet dressing, and hydrocolloid wound dressing were applied topically once a day to the first, second, and third groups, respectively. No dressing was applied to the positive and negative control groups. Index of oxidative stress of wound healing was assessed by total antioxidant status/total oxidant status measurements. Results: Due to the macroscopic results, it was determined that wound score was significantly decreased on day 3 in the first group and non-diabetic groups compared with other groups. When the microscopic findings were compared with day 0, in the first group, significant decrease of the level of collagen density and epithelization was observed on day 10. In the first group, increase in fat cells had become significant than other groups. In the CD34, SMA and vimentin staining, the first group showed superiority to other dressings. In the last measurements, the highest drop was seen in geraniol dressed and negative control groups. Conclusion: According to the study, geraniol dressed group provided similar wound healing with negative control group and showed superiority to the other products used as a standard in wound care.

Clinical Outcome of COVID-19 Infection on Chronic Diabetic Complications Patients

Introduction: COVID-19 is an infectious disease resulting from the SARS-CoV-2 virus. The virus targets the respiratory system and leads to a significant number of fatalities worldwide. Consequently, it was officially classified as a pandemic in 2020. The Covid varians is now being monitored by the World Health Organization. Diabetes mellitus is one of the disorders that might deteriorate following an infection. Diabetes mellitus and its associated comorbidities continue to pose a significant health challenge in Indonesia, while it is also a focus of concern of the Sustainable Development Goals (SDGs). The study was aimed to assess the risks and outcomes associated with COVID-19 infection and the long-term consequences of diabetes mellitus.Methods: This was a descriptive study using a retrospective design. Research data were taken from the medical records of patients confirmed positive for COVID-19 infection and also had chronic complications of diabetes mellitus who were treated at Dr Soetomo General Academic Hospital, Surabaya, Indonesia in 2021. There were 156 patients who met the criteria of this research.Results: There were 156 patients (97 males, 59 females). The average age of the patients was 58, while most of the patients (84%) died and the rest of the patients (16%) survived. Most of the patients with fatality (55.8%) were those with critical severity level and complications of microangiopathy, while the patients who survived (10.3%) were those with moderate severity level and complications of microangiopathy. Conclusion: COVID-19 patients with diabetes and comorbidities had a higher mortality rate than those who recovered, while most of the patients with fatality were those with significant COVID-19 and diabetic microangiopathy complications.

Prevalence of Diabetes Mellitus and Chronic Complications of Diabetes Mellitus in District Buner Khyber Pakhtunkhwa, Pakistan

Background: Diabetes Mellitus (DM) is a significant global public health concern, particularly in developing countries like Pakistan. The Buner District of Khyber Pakhtunkhwa, Pakistan, presents a unique demographic and geographical setting for studying the prevalence and chronic complications of DM. Objective: This study aimed to assess the prevalence of diabetes mellitus and its chronic complications in the Buner District, Khyber Pakhtunkhwa, Pakistan, and to understand the demographic distribution of the disease. Methods: A comprehensive, area-specific study was conducted from March 2022 to August 2022, involving 753 patients across eight localities in the Buner District. Data were collected using questionnaires, interviews, and observations at various medical centers. Participants included individuals from both rural and urban areas, with a demographic split of 486 males (64.54%) and 267 females (35.45%). The study also investigated six types of chronic complications associated with DM. Data analysis was performed using Microsoft Excel 2016 and SPSS version 25. Results: The study found that the prevalence of diabetes mellitus in the Buner District was significantly high, with a higher incidence in urban areas compared to rural ones. The prevalence of chronic complications of DM varied, with cardiovascular conditions being the most prominent, followed by neuropathy, nephropathy, ocular conditions, and foot diseases. Conclusion: The study highlights a high prevalence of diabetes mellitus and its chronic complications in the Buner District, with urban areas showing a higher incidence. The findings underscore the need for targeted healthcare strategies and interventions in this region to address the growing burden of DM.

MicroRNA-150 (miR-150) as a Potential Biomarker for Diabetic Retinopathy

Diabetic retinopathy (DR) is a known chronic complication of diabetes mellitus and is one of the leading causes of visual impairment. The chronic inflammation associated with DR poses large risks not only for the vasculature but also for the surrounding neuronal tissue. Potential biomarkers, especially those surrounding microRNAs (miRNAs), have been proposed to indicate the progression of DR. Levels of certain miRNAs have been shown to be either down or upregulated in type 1 diabetes patients and have shown correlations with specific types of DR. MicroRNA-150 (miR-150) has also been shown to have protective effects on cells in hypoxic environments, but when downregulated, miR-150 actually induces apoptosis. And, it has been shown to be downregulated in patients with type 1 and type 2 diabetes as well as patients with obesity. We hypothesize then that the levels of miR-150 from a peripheral blood sample should be indicative of the progression of DR and may be used for potential early intervention. In this project, we assessed miR-150 levels in the peripheral blood mononuclear cells (MNCs) of individuals with different severities of DR by isolating mononuclear cells and extracting RNA. We then reverse-transcribed the RNA into cDNA and used RT-qPCR to measure the levels of miR-150 in individuals with varying DR severity. MiR-150 levels in the MNCS were decreased in individuals with diabetes with no retinopathy, moderate NPDR and severe NPDR groups when compared to control individuals; however, there was a marginal increase in the miR-150 mild NPDR group. The data could show evidence that a peripheral blood draw could be used as a less invasive approach to assessing the severity of diabetic retinopathy in patients. This would change the disease management and future treatments individually.

IL-33/ST2L signaling alleviates diabetic nephropathy by regulating endoplasmic reticulum stress and apoptosis

ObjectiveDiabetic nephropathy (DN) is a serious chronic complication of diabetes mellitus (DM). Endoplasmic reticulum (ER) stress is an important factor in the regulation of pathological processes in DN, and excessive ER stress can lead to apoptosis. Although the IL-33/ST2 axis is known to be involved in diabetic kidney disease or related nephropathy, its role and molecular mechanisms remain poorly understood in terms of DN. The purpose of this study was to investigate the effects of IL-33/ST2 signaling on DN and to characterize the roles that ER stress and apoptosis play in DN.MethodsTo investigate this study, mice were randomly assigned into DN (induced by 0.1% STZ) and Control groups. Biochemical indices (FBG, BUN, UPR, UCE) were measured in serum and urine samples to reflect blood glucose and kidney damage. Quantitative real-time PCR, western blot, and immunofluorescence were used to assess gene and protein expression of the IL-33/ST2 axis and ER stress relative signaling molecule. Apoptosis was analyzed by flow cytometry.ResultsIL-33 levels are significantly increased in the kidneys of patients and mice with DN. Double immunofluorescence staining showed that IL-33 colocalized with CD31-positive endothelial cells. Treatment with IL-33 attenuated kidney injury in Streptozotocin (STZ)-treated mice. In vitro, we showed that IL-33 attenuated ER stress and apoptosis in glomerular endothelial cells. However, sST2 treatment significantly reversed these effects of IL-33.ConclusionTogether, these data suggest that IL-33/ST2 signaling mitigates STZ-induced renal damage, partly at least, by suppressing ER stress and apoptosis. Therefore, IL-33 may be an effective therapeutic target in DN.

Features of the course of type 1 diabetes mellitus and its complications against the background of undifferentiated connective tissue dysplasia

Changes in connective tissue against the background of hyperglycemia in patients with type 1 diabetes mellitus is a morphological substrate for the formation of diabetic complications. The presence of undifferentiated connective tissue dysplasia in a patient with absolute insulin deficiency, the prevalence of individual external manifestations of which among young people is 85.4%, can increase the risk of developing and progressing complications of diabetes mellitus. The purpose of the review is to summarize the literature data on the impact of undifferentiated connective tissue dysplasia on the course of type 1 diabetes mellitus and its complications when they are combined in one patient. An analysis of the literature has shown that today there are single studies that have studied the specifics of the course of type 1 diabetes mellitus and its complications against the background of undifferentiated connective tissue dysplasia, with some aspects analyzed in children and adolescents, others in adults, which does not allow to draw clear conclusions. The results of these studies demonstrated earlier development and progression of such diabetic complications as nephropathy, neuropathy, post-injection lipodystrophy in patients with increased dysplastic stigma. According to some experts, patients with type 1 diabetes mellitus and concomitant undifferentiated connective tissue dysplasia should be allocated to a separate group of dispensary observation, since they may have a higher risk of developing and progressing rate of chronic complications of diabetes mellitus, which leads to a concomitant decrease in quality of life and increased risk of disability. However, to date, the question of the influence of increased dysplastic stigmatization on the course of type 1 diabetes mellitus has not been fully studied.

Adenosine Deaminase and Guanine Deaminase: The Potential Role in Diabetic Foot Ulcers

     The present study explored the possible role of adenosine deaminase and guanine deaminase in diabetic foot ulcers which is considered one of the main chronic complications of diabetes mellitus. Serum adenosine deaminase, guanine deaminase, and some biochemical parameters were investigated in 54 patients with diabetic foot ulcers and 40 healthy individuals. According to our findings, adenosine deaminase and guanine deaminase activities are much higher in diabetic foot ulcer patients than in healthy individuals. A strong positive correlation was found between adenosine deaminase and guanine deaminase activities. Adenosine deaminase and guanine deaminase had 100% sensitivity and specificity for diagnosing diabetic foot ulcers, and their area under the receiver operating characteristic curve was 1.0. Kinetic study displayed significant changes in Vmax and Km between patients and healthy individuals for both adenosine deaminase and guanine deaminase. Based on results, it can be concluded that the increase of adenosine deaminase and guanine deaminase activities may negatively contribute in diabetic foot ulcers progression.

Schefflera arboricola Tablets Relieve Diabetic Neuropathic Pain: Involvement of Oxidative Stress and Inflammation

Background Diabetic neuropathic pain (DNP) is a serious chronic complication of diabetes mellitus. Oxidative stress and inflammation are considered the central mechanisms of its pathogenesis. Schefflera arboricola (SA) is a Schefflera plant of the Araliaceae family that has the effect of pain relief. In this study, the effect of SA on DNP was first investigated. Materials and Methods Diabetic neuropathy in rats was induced by a single injection of streptozotocin (60 mg/kg). Three weeks later, SA (100 mg/kg, 300 mg/kg) or gabapentin (100 mg/kg) was given once a day for a week. Blood glucose, body weight, and thermal withdrawal latency in DNP rats were measured. The morphology of the sciatic nerve was observed by light microscopy and toluidine blue staining. Semiquantitative analysis of myelin basic protein (MBP) of the sciatic nerve was performed by immunohistochemistry. IL-1β, tumor necrosis factor-alpha (TNF-α), and IL-6 were detected by enzyme-linked immunosorbent assay. Commercial reagent kits were used to detect inducible nitric oxide synthase, superoxide dismutase (SOD), and malondialdehyde (MDA). The expression levels of nuclear factor erythroid-2-related factor 2 (Nrf2) and nuclear factor-kappa B (NF-κB) were detected by Western blot. Results DNP rat model was successfully constructed. SA and gabapentin could alleviate the thermal sting pain of DNP rats, increase the expression of MBP and SOD, and decrease the expression of proinflammatory agents and MDA. Moreover, SA could reverse the upregulation of NF-κB and the downregulation of Nrf2. Conclusion SA has a significant protective effect on DNP, manifesting in the improvement of allodynia and sciatic nerve pathology, inhibition of neuroinflammation, reduction of oxidative stress, enhancement of Nrf2, and inhibition of NF-κB.

Case Study of Ozone Bagging Adjuvant Therapy in Wagner II and III Diabetic Foot Ulcers on Wound Healing Process: Three Patients Recovered Completely

Background: Diabetic foot ulcer is a chronic complication of diabetes mellitus in the form of ulceration with or without infection. Diabetic foot ulcers that are not handled properly can cause damage to the foot that requires amputation. Wound care techniques for treating diabetic foot ulcers are starting to develop, one of which is ozone bagging therapy. This ozone bagging therapy in diabetic foot ulcers is reported to be useful as an anti-microbial effect, increasing glycemic control, increasing insulin sensitivity, preventing oxidative stress, increasing fibroblast proliferation, and increasing the release of growth factors. This case study will report 3 patients with Wagner II and III-foot ulcers who healed completely within 28 days using ozone bagging treatment as an adjuvant. Methods: 3 patients with diabetic foot ulcers Wagner II and III received ozone bagging therapy every 4 days for 7 sessions (a total of 28 days) as an additional therapy besides treating moist gauze using NaCl. This study used a Medical Ozone Generator. The dose of ozone used with medical oxygen is 1 lpm, flow 0.6, in the first session "high dose" with an output dose of 80-100 mg/l and in the 2nd-7th session with a low dose (25-35 mg/l). Macroscopic assessment of the wound using the Wagner scale and the progress of each treatment session is documented in photographs. Results: On macroscopic measurements, the process of wound healing leading to wound closure was better in the treatment group and was taken as a case for 3 patients who recovered completely. It resulted in 3 patients who recovered completely with a measurement of the Meggitt-Wagner scale of 0.26. Conclusion: For these recovered patients, there was a decrease in VEGF, TGF-β, and PDGF levels. The VEGF, TGF-β, and PDGF levels tested were VEGF, TGF-β, and PDGF levels in wound exudate by comparing them on the 3rd day. 1st and 12th day. Supported by macroscopic data showing that the wound healing process was better in the group that received ozone bagging therapy as an adjuvant. From this study it was found that the trend of decreasing levels of VEGF, TGF-β, and PDGF in wound exudate occurred because the inflammatory and proliferative processes in the treatment group lasted more faster than the control group. Keywords: ozone bagging therapy, diabetic ulcers, wound exudate, growth factors, VEGF, TGF-β, and PDGF, Meggitt-Wagner scale.

Advances in cardiovascular-related biomarkers to predict diabetic peripheral neuropathy.

Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus. One of the most common types is distal symmetric poly-neuropathy, which begins as bilateral symmetry pain and hyperesthesia and gradually progresses into hypoesthesia with nerve fibre disorder and is frequently accompanied by depression and anxiety. Notably, more than half of patients with DPN can be asymptomatic, which tends to delay early detection. Furthermore, the study of adverse outcomes showed that DPN is a prominent risk factor for foot ulceration, gangrene and nontraumatic amputation, which decreases quality of life. Thus, it is essential to develop convenient diagnostic biomarkers with high sensitivity for screening and early intervention. It has been reported that there may be common pathways for microvascular and macrovascular complications of diabetes. The pathogenesis of both disorders involves vascular endothelial dys-function. Emerging evidence indicates that traditional and novel cardiovascular-related biomarkers have the potential to characterize patients by subclinical disease status and improve risk prediction. Additionally, beyond traditional cardiovascular-related biomarkers, novel cardiovascular-related biomarkers have been linked to diabetes and its complications. In this review, we evaluate the association between major traditional and nontraditional car-diovascular-related biomarkers of DPN, such as cardiac troponin T, B-type natriuretic peptide, C-reactive protein, myeloperoxidase, and homocysteine, and assess the evidence for early risk factor-based management strategies to reduce the incidence and slow the progression of DPN.

Upregulation of circ_0080968 in diabetic foot ulcer inhibits wound healing via repressing the migration and promoting proliferation of keratinocytes

BackgroundDiabetic foot ulcer (DFU) is a serious chronic complication of diabetes mellitus whose pathogenesis remains unclear. Circular RNA (circRNA) refers to a group of covalently closed non-coding RNAs that are reported to be dysregulated in patients with DFU. However, the mechanism whereby dysregulation in circRNAs contributes to DFU remains unclear. In this study, we investigated the role of dysregulated circRNAs in DFU. Materials and methodsA gene expression dataset was downloaded from the Gene Expression Omnibus portal and analyzed by the limma package of R. The levels of 24 upregulated circRNAs were detected in two independent cohorts by RT-qPCR. Interactions between miRNAs and circRNAs were predicted through bioinformatics and confirmed using a dual luciferase assay. The circularity and subcellular localization of circRNA-080968 was examined by northern blotting after digestion with RNase-R and in situ hybridization. Cell migration and proliferation were examined using Transwell and MTT assays. The apoptotic cells were detected by flow cytometry. ResultsThe level of circRNA-080968 was upregulated in DFU tissues compared to that of non-DFU samples and normal human wounds. CircRNA-080968 was mainly localized in the cytoplasm and its overexpression inhibited the migration and promoted the proliferation of keratinocytes. MiR-326 and miR-766-3p were identified to interact with and be negatively correlated with circRNA-080968 levels. Increased glucose upregulated circRNA-080968, and its overexpression accelerated the degradation of both miR-326 and miR-766-3p. Reduced levels of miR-326 and miR-766-3p upregulated the expression of several genes controlling cell adhesion and proliferation which are related to the pathogenesis of DFU. ConclusionsThe upregulation of circRNA-080968 in DFU induced the degradation of miR-326 and miR-766-3p, which further repressed the migration and increased the proliferation of keratinocytes.

Eugenia sonderiana O. Berg leaves: Phytochemical characterization, evaluation of in vitro and in vivo antidiabetic effects, and structure-activity correlation

Several medicinal plants have drawn the attention of researchers by its phytochemical composition regarding their potential for treating chronic complications of diabetes mellitus. In this context, plants of the Myrtaceae family popularly used in Brazil for the treatment of diabetes mellitus, including Eugenia sonderiana, have shown beneficial effects due to the presence of phenolic compounds and saponins in their chemical constitution. Thus, the present work aimed to perform the phytochemical characterization of the hydroethanolic extract of E. sonderiana leaves using high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS), along with in vitro and in vivo studies of antidiabetic activity. The chemical characterization revealed the presence of phenolic compounds, flavonoids, neolignans, tannins, and saponins. In addition, the extract exhibited minimum inhibitory concentrations of alpha-amylase and alpha-glycosidase higher than the acarbose in the in vitro tests. Also, the in vivo tests revealed a slight increase in body mass in diabetic rats, as well as a significant decrease in water and feed consumption provided by the extract. Regarding serum biochemical parameters, the extract showed significant activity in decreasing the levels of glucose, hepatic enzymes, and triglycerides, in addition to maintaining HDL cholesterol levels within normal ranges, protecting the cell membranes against oxidative damage. Thus, the extract of E. sonderiana leaves was considered promising pharmaceutical ingredient in the production of a phytotherapy medication.

Tight junction disruption and the pathogenesis of the chronic complications of diabetes mellitus: A narrative review.

The chronic complications of diabetes mellitus constitute a major public health problem. For example, diabetic eye diseases are the most important cause of blindness, and diabetic nephropathy is the most frequent cause of chronic kidney disease worldwide. The cellular and molecular mechanisms of these chronic complications are still poorly understood, preventing the development of effective treatment strategies. Tight junctions (TJs) are epithelial intercellular junctions located at the most apical region of cell-cell contacts, and their main function is to restrict the passage of molecules through the paracellular space. The TJs consist of over 40 proteins, and the most important are occludin, claudins and the zonula occludens. Accumulating evidence suggests that TJ disruption in different organs, such as the brain, nerves, retina and kidneys, plays a fundamental pathophysiological role in the development of chronic complications. Increased permeability of the blood-brain barrier and the blood-retinal barrier has been demonstrated in diabetic neuropathy, brain injury and diabetic retinopathy. The consequences of TJ disruption on kidney function or progression of kidney disease are currently unknown. In the present review, we highlighted the molecular events that lead to barrier dysfunction in diabetes. Further investigation of the mechanisms underlying TJ disruption is expected to provide new insights into therapeutic approaches to ameliorate the chronic complications of diabetes mellitus.

Bibliometric and visual analysis of diabetes mellitus and pyroptosis from 2011 to 2022

ObjectiveTo visualize and analyze the published literature on diabetes mellitus and pyroptosis based on a bibliometric approach, so as to provide a comprehensive picture of the hot research directions and dynamic progress in this field.MethodsThis study was based on the web of science core collection database to conduct a comprehensive search of the published literature in the field of diabetes mellitus and Pyroptosis from January 1985 to August 2022, including the published research literature in this field, as well as a visual analysis of the number of citations, year of publication, journal, author, research institution, country, and research topic.ResultsA total of 139 literature on research related to diabetes mellitus and cellular scorch from 2011 to 2022 were retrieved, with a total of 3009 citations and a maximum of 255 citations for a single article, which had a first author Schmid-Burgk, JL The first author of this article is from Germany; among 20 publishing countries, China leads with 100 articles; among 222 publishing institutions, Harbin Medical University leads with 18 articles and 184 citations; among 980 authors, Chen, X from China tops the list of high-impact authors with 5 articles and 29 citations. Among the 98 journals, "CELL DEATH DISEASE" ranked first in both volume and high-impact journals with 4 articles and 29 citations. Among 349 keywords, "pyroptosis" ranked first with a cumulative frequency of 65 times. The cluster analysis was divided into three categories, chronic complications of diabetes mellitus and pyroptosis (67 articles), diabetes mellitus and pyroptosis (60 articles), and diabetes mellitus combined with other diseases and pyroptosis (12 articles), and the number of articles related to diabetes mellitus and its chronic complications increased rapidly from 2019, among which, diabetic cardiomyopathy (27 articles) had the highest number of articles.ConclusionsBased on a comprehensive analysis of published literature in the field of diabetes mellitus and pyroptosis from 2011 to 2022, this study achieved a visual analysis of studies with significant and outstanding contributions to the field, thus framing a picture showing the development and changes in the field. At the same time, this study provides research information and direction for clinicians and investigators to conduct diabetes mellitus and pyroptosis-related research in the future.

Preclinical study of diabetic foot ulcers: From pathogenesis to vivo/vitro models and clinical therapeutic transformation.

Diabetic foot ulcer (DFU), a common intractable chronic complication of diabetes mellitus (DM), has a prevalence of up to 25%, with more than 17% of the affected patients at risk of amputation or even death. Vascular risk factors, including vascular stenosis or occlusion, dyslipidemia, impaired neurosensory and motor function, and skin infection caused by trauma, all increase the risk of DFU in patients with diabetes. Therefore, diabetic foot is not a single pathogenesis. Preclinical studies have contributed greatly to the pathogenesis determination and efficacy evaluation of DFU. Many therapeutic tools are currently being investigated using DFU animal models for effective clinical translation. However, preclinical animal models that completely mimic the pathogenesis of DFU remain unexplored. Therefore, in this review, the preparation methods and evaluation criteria of DFU animal models with three major pathological mechanisms: neuropathy, angiopathy and DFU infection were discussed in detail. And the advantages and disadvantages of various DFU animal models for clinical sign simulation. Furthermore, the current status of vitro models of DFU and some preclinical studies have been transformed into clinical treatment programs, such as medical dressings, growth factor therapy, 3D bioprinting and pre-vascularization, Traditional Chinese Medicine treatment. However, because of the complexity of the pathological mechanism of DFU, the clinical transformation of DFU model still faces many challenges. We need to further optimize the existing preclinical studies of DFU to provide an effective animal platform for the future study of pathophysiology and clinical treatment of DFU.

Progress in the Study of Glycosylated Haemoglobin Variability Index in Relation to Chronic Complications of Diabetes Mellitus

Diabetes mellitus (DM) is a common endocrine disease that can cause damage to tissues and organs throughout the body. Glycosylated haemoglobin (HbA1c) is considered to be the gold standard for assessing glycaemic control and treatment outcomes in patients with diabetes, but there is individual variability that affects the accurate interpretation of blood glucose. The glycosylated haemoglobin variability index (HGI) is a measure of individual variability in HbA1c and can be used in the management and treatment of patients with DM. In this paper, the relationship between HGI and chronic complications of DM is reviewed and discussed, with the aim of providing a more individualized and accurate reference for clinical management of blood glucose and risk assessment of chronic complications in DM patients, reducing and delaying the occurrence of chronic complications of diabetes and improving the quality of life of DM patients.