BackgroundImpaired wound healing in diabetic patients remains a major clinical challenge due to oxidative stress, chronic inflammation, and compromised tissue regeneration.ObjectiveThis study aimed to develop and evaluate a novel nanocomposite hydrogel system incorporating lipoic acid and melatonin to enhance diabetic wound healing.MethodsChitosan nanoparticles co-loaded with lipoic acid and melatonin (LAMELCNPs) were embedded within a calcium alginate hydrogel to form a bioactive wound dressing (LAMELCNPHYD). The system was characterized in terms of its microstructure, swelling behavior, drug release profile, cytocompatibility, antioxidant capacity, anti-inflammatory activity, and hemocompatibility. In vivo wound healing efficacy was assessed using a streptozotocin-induced diabetic rat model.ResultsScanning electron microscopy (SEM) confirmed the porous hydrogel structure. LAMELCNPHYD showed sustained drug release, excellent cytocompatibility, and enhanced antioxidant and anti-inflammatory activity. In vivo, LAMELCNPHYD significantly improved wound closure, collagen deposition, epithelial regeneration, and modulation of inflammatory markers (reduced interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and matrix metalloproteinase-9 (MMP-9); increased transforming growth factor-beta 1 (TGF-β1) and vascular endothelial growth factor (VEGF)).ConclusionThe LAMELCNPHYD hydrogel demonstrated potent wound healing efficacy through combined antioxidative, anti-inflammatory, and regenerative mechanisms, offering a promising therapeutic strategy for diabetic wound management.

Diabetes mellitus (DM) is a globally growing chronic disease and is associated with numerous complications. In recent years, its potential impact on cognitive functions has gained increasing attention. This study was conducted to investigate the relationship between cognitive performance and micronutrient status in non-geriatric individuals with type 2 DM (T2DM). This case-control study included 120 patients with T2DM aged 18-65 years. Patients with cognitive impairment constituted the case group, while age-matched patients without cognitive impairment served as controls, based on Montreal Cognitive Assessment scores. Individuals with malabsorption syndromes, severe acute or chronic illnesses, prior gastrointestinal surgery, dementia, Parkinson's disease, cerebrovascular events, psychiatric disorders, use of cognition-affecting medications, or micronutrient supplementation were excluded. Fasting blood glucose (FBG), HbA1c, renal and liver function tests, total protein, albumin, iron, zinc, magnesium, calcium, vitamin B12, folate, and vitamins A, C, D, and E were measured and compared between groups. 75 females and 45 males, a total of 120 patients were included in the study. The mean age was 53.0 ± 8.4 years. Cognitive dysfunction was present in 50% of the patients. There were no statistically significant differences in the levels of FBG, HbA1c, urea, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total protein, folic acid, vitamin A, vitamin C, vitamin E according to age, gender, and cognitive dysfunction variables. Albumin, iron, zinc, magnesium, calcium, vitamin B12, vitamin D levels were significantly lower in the group with cognitive dysfunction than in the group without cognitive dysfunction. Albumin, iron, zinc, magnesium, calcium, vitamin B12, vitamin D levels in univariate model and iron, magnesium, calcium, vitamin B12 levels in multivariate model were effective in differentiating patients with and without cognitive dysfunction. This study shows that there is a significant relationship between cognitive functions and micronutrient levels in non-geriatric patients with DM. Screening of micronutrient levels and appropriate replacement of deficiencies during diabetes management is important for the protection and improvement of cognitive functions.

Janus hydrogel combines anti-freezing and adhesive properties for sweat glucose monitoring.

Impact of a continuous glucose monitor-wearing experience on student counseling in a skills-based pharmacy laboratory.

Integrating personal continuous glucose monitoring use into a third-year therapeutics course: Reflections on combining the experiential with the didactic.

Developing a family-centered psychoeducational program to support adults with diabetes: A theory-driven approach.

Activating the cellular scavenger: A bioactive hydrogel promotes diabetic wounds via plant exosome-like nanovesicles enhanced macrophage efferocytosis.

pH-gated dual-modal switch photothermal cascade nanozyme hydrogel for diabetic infectious wound healing.

Infection-adaptive polysaccharide hydrogels integrating ginsenoside Rb1@ZIF-8 nanozyme for diabetic wound healing.

Laser-induced flexible Cu@NC/graphene electrode integrated with smartphone for on-site and non-enzymatic glucose monitoring.

The nutritional evaluation and hypoglycemic activity of chickpea (Cicer arietinum L.) proteins in vivo based on network pharmacology.

A synergistic strategy via trace cobalt doping: Mesoporous engineering and electronic structure modulation of ZIF-8 derivatives for superior acetone sensing detection.

Diabetes resilience is key to adolescents' effective type 1 diabetes management. This descriptive, cross-sectional study examined the relationships between diabetes resilience scores and behavioral and health indicators and individual and family factors in 202 older adolescents (aged 14-18 years) with type 1 diabetes presenting to a pediatric endocrinology outpatient clinic and ward in Türkiye. Data were collected using a background information form and the Diabetes Strengths and Resilience Measure for Adolescents with Type 1 Diabetes (DSTAR-Teen). Higher DSTAR-Teen scores were associated with higher maternal education level, absence of sibling diabetes, shorter diabetes duration, at least four blood glucose self-checks daily, and three or fewer hyperglycemic episodes in the last month (p < 0.05). DSTAR-Teen scores negatively correlated with HbA1c (p = 0.001) and postprandial blood glucose levels (p < 0.05). Understanding the factors associated with diabetes resilience in adolescents with type 1 diabetes may enable the development of targeted interventions to support diabetes management.

Perceptions and experiential strategies of alcohol use in emerging adults with type 1 diabetes: A qualitative study.

Automated insulin delivery (AID) has been established as an effective therapy for individuals with type 1 diabetes. This analysis evaluates the clinical and economic outcomes of AID compared with multiple daily injections plus continuous glucose monitoring (MDI/CGM) in adults with type 2 diabetes. The IQVIA CORE Diabetes Model v10.0 was employed to simulate the impact of using the t:slim X2 insulin pump with Control-IQ+ technology (Control-IQ+) versus MDI/CGM over a 50-year period using data from the 2IQP randomized controlled trial (NCT05785832). Trial data informed cohort demographics, intervention effects and resource utilization while literature sources provided health state utilities and costs. Scenario analyses examined the effect of Control-IQ+ on reducing HbA1c based on alternative HbA1c progression estimates from the Swedish National Diabetes Registry and alternative resource use and treatment effects from real-world evidence. The base case analysis indicated that direct medical costs per individual for type 2 diabetes management with Control-IQ+ were $239 935 compared to $209 792 with MDI/CGM use. Control-IQ+ resulted in 0.51 additional quality-adjusted life years (QALYs: 10.36 vs. 9.85 for MDI/CGM), yielding an incremental cost-effectiveness ratio (ICER) of $59 417 per QALY, 95% CI: ($55 836, $62 998). In probabilistic sensitivity analyses, 89% of simulations produced ICERs below $100 000/QALY. ICERs across all scenarios remained below $100 000 per QALY. Control-IQ+ is associated with increased life expectancy, higher QALYs and reduced complication rates. These findings suggest that Control-IQ+ is cost-effective relative to MDI/CGM for managing patients with type 2 diabetes in the United States.

Diabetes mellitus poses a significant public health challenge in Sub-Saharan Africa (SSA), exacerbated by healthcare limitations, socioeconomic disparities and sociocultural factors affecting disease management. Medication adherence is critical for glycaemic control but remains suboptimal in this region. This review synthesises evidence on adherence to antidiabetic medications in SSA, identifies key determinants and suggests strategies to improve adherence. A systematic review was conducted following PRISMA 2020 guidelines by searching PubMed, Scopus, Web of Science and African Journals Online for studies published between January 2015 and May 2025. Studies involving diabetic patients in SSA and assessing medication adherence were included. Data were extracted using a standardized form, and methodological quality was assessed using the Newcastle-Ottawa Scale. Twenty-six studies with over 6500 participants from 10 SSA countries were included. Adherence rates varied from 13.9% to 84.5%, with most settings reporting moderate to low adherence. Key determinants of non-adherence included socioeconomic barriers, therapy-related factors, health system limitations, and sociocultural influences. Effective interventions need to be culturally sensitive and address these multidimensional barriers. Future research should focus on longitudinal and interventional designs.

Metformin suppresses β-cell apoptosis under ER stress by inhibiting protein translation.

Type 1 diabetes intervention clusters in resource-limited settings: a systematic review and economic evaluation.

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are well-known medications commonly prescribed for type 2 diabetes management and pharmacologic management of obesity. While GLP-1 RAs have many positive effects on glycemic control and cardiovascular health, the secondary effect of weight loss can present a challenge in maintaining optimal prosthesis fitting and functionality among individuals with prosthetic limbs. More specifically, weight loss can lead to decreased muscle mass and volume of the residual limb, resulting in loosening of the prosthesis. In turn, individuals often require more frequent prosthetic adjustments to ensure their safety and comfort while using the prosthetic device. Herein, we describe 3 cases of semaglutide use in patients with prosthetic limbs who subsequently presented with a variety of complications, including skin breakdown, disproportionate residual limb volume loss, decreased prosthetic use, and increased residual limb pain. Such "Ozempic limbs" have not yet been reported in the literature. These observations suggest that further research in GLP-1 RA selection is required for persons with amputation, as well as increased patient education regarding the unique complications.

BACKGROUND Tirzepatide is a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved for type 2 diabetes and chronic weight management in adults meeting clinical criteria. Appetite suppression and gastrointestinal intolerance can markedly reduce intake. This report describes a 30-year-old woman with tirzepatide-associated euglycemic ketoacidosis after unsupervised use of tirzepatide obtained without a prescription for weight loss, despite having no history of obesity or diabetes. CASE REPORT A 30-year-old woman with a body mass index of 24.8 kg/m² and no known diabetes presented with 4 days of severe nausea, approximately 10 vomiting episodes daily, poor intake, and periumbilical abdominal pain. She had self-administered tirzepatide 2.5 mg once weekly and increased the dose to 5 mg 1 week before presentation. Initial testing showed high anion gap metabolic acidosis with a pH of 7.15, bicarbonate level of 10.5 mEq/L, and an anion gap of 24. Lactate was in the normal range. Urine ketones were positive, serum ketones measured 4.5 mmol/L, and glucose level was 4.2 mmol/L. Acidosis persisted after administration of 1.5 L crystalloid, prompting intensive care unit admission. Tirzepatide was stopped. She received 10% dextrose, lactated Ringer's solution, thiamine, antiemetics, electrolyte monitoring and replacement, and gradual refeeding. The anion gap closed and ketones normalized within 36 hours, without bicarbonate therapy or insulin infusion. CONCLUSIONS Tirzepatide-related nausea, vomiting, and caloric deprivation can be associated with significant euglycemic ketoacidosis even without diabetes or obesity. Clinicians should consider starvation ketoacidosis in tirzepatide users with vomiting, poor intake, abdominal pain, and high anion gap metabolic acidosis.