Treatment Of Type 2 Diabetes Mellitus Research Articles

Design, Synthesis, and Biological Evaluation of Covalently Mucoadhesive Derivatives as Nonsystemic Intestine-Targeted TGR5 Agonists.

Takeda G-protein-coupled receptor 5 (TGR5) is considered a promising therapeutic target for treating type 2 diabetes mellitus (T2DM), obesity, and other metabolism-related diseases. Although many TGR5 agonists have been identified, they might cause some side effects in the gallbladder and the heart. To reduce these side effects and improve glucose-lowering capability, we first designed and synthesized a series of 4-phenoxynicotinamide intestine-targeted TGR5 agonist derivatives containing maleimides in the side chains with different linker lengths. All of the target compounds demonstrated significant TGR5 agonistic activity, among which compound 22b displayed the best TGR5 agonistic activity. Additionally, compound 22b displayed low Caco-2 cell permeability and strong mucoadhesion to mucin and the rat intestine. In C57BL/6J, diet-induced obese, and db/db mice, compound 22b demonstrated a robust and prolonged hypoglycemic effect along with an acceptable safety profile.

EFFECT OF DAHLIA TUBER INULIN EXTRACT ON FATTY LIVER IN TYPE 2 DIABETES MELLITUS RATS

Several studies show a correlation between intestinal microbiota disturbances and metabolic disorders, including type 2 diabetes mellitus (T2DM). Fatty liver is one of the complications that occurs due to T2DM. Fatty liver is characterized by the accumulation of lipids in the liver in response to increased triglyceride synthesis in hepatocytes and is thought to be associated with disturbances in the gut microbiota so that changes in the gut microbiota can be a potential target for T2DM treatment. It is known that inulin, a prebiotic, can improve intestinal microbiota disorders. This study aims to analyze the effect of administering inulin from dahlia tubers on fatty liver in T2DM rats.The research design is an experimental study with a post-test-only control group design conducted from June to November 2023. The study used twenty male Rattus norvegicus Wistar strain divided into five groups: a control group, a T2DM-induced group, T2DM groups given inulin extract at doses of 0.5 mg/gBW, 1.0 mg/gBW, and 1.5 mg/gBW. The results showed that the T2DM group had a higher significant percentage of fatty liver (p <0.01) than the control group. Compared to the T2DM group, there was a decrease in the percentage of fatty liver in the T2DM groups given inulin at all doses (p<0.05). This study concluded that inulin administration can reduce fatty liver in T2DM rats. Keywords : Dahlia tubers., fatty liver., inulin., type 2 diabetes mellitus

Plant-Derived Flavonoids as AMPK Activators: Unveiling Their Potential in Type 2 Diabetes Management through Mechanistic Insights, Docking Studies, and Pharmacokinetics

Type 2 diabetes mellitus (T2DM) remains a significant global health issue, marked by insulin resistance and disrupted glucose metabolism. AMP-activated protein kinase (AMPK) serves as a key regulator of cellular energy balance, playing a crucial role in enhancing insulin sensitivity, promoting glucose uptake, and reducing glucose production in the liver. Recently, there has been growing interest in plant-derived flavonoids as natural activators of AMPK, offering a promising complementary approach to conventional diabetes treatments. This review delves into ten flavonoids identified as AMPK activators, including baicalein, dihydromyricetin, bavachin, 7-O-MA, derrone, and alpinumisoflavone. Their activation mechanisms are explored, which include both direct binding to the AMPK complex and indirect pathways involving upstream signaling. Through molecular docking studies, the binding affinities and interaction profiles of these flavonoids with AMPK are assessed, revealing varying levels of activation potential. Notably, baicalein and dihydromyricetin showed strong binding to the α1 subunit of AMPK, indicating high potential for robust activation. Additionally, this review provides a thorough analysis of the pharmacokinetic properties and drug-likeness of these flavonoids using the SwissADME tool, focusing on aspects such as ADME (Absorption, Distribution, Metabolism, and Excretion). While the overall profiles of these compounds are promising, issues like solubility and possible drug–drug interactions are areas that need further refinement. In summary, plant-derived flavonoids emerge as a promising avenue for developing new natural therapies for T2DM. Moving forward, research should aim at optimizing these compounds for clinical application, elucidating their specific mechanisms of AMPK activation, and confirming their efficacy in T2DM treatment. This review highlights the potential of flavonoids as safer and more holistic alternatives or adjuncts to current diabetes therapies.

The role of islet autoantigen-specific T cells in the onset and treatment of type 1 diabetes mellitus.

Type 1 diabetes mellitus (T1DM), a complex chronic disease with an intricate etiology and pathogenesis, involves the recognition of self-antigens by pancreatic islet autoantigen-specific T cells and plays crucial roles in both early- and late-stage destruction of beta cells, thus impacting disease progression. Antigen-specific T cells regulate and execute immune responses by recognizing particular antigens, playing broad roles in the treatment of various diseases. Immunotherapy targeting antigen-specific T cells holds promising potential as a targeted treatment approach. This review outlines the pathogenesis of diabetes, emphasizing the pivotal role of pancreatic islet autoantigen-specific T cells in the progression and treatment of T1DM. Exploring this avenue in research holds promise for identifying novel therapeutic targets for effectively managing diabetes.

Combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin in the treatment of type 2 diabetes mellitus combined with heart failure: a systematic evaluation and meta-analysis based on a randomized controlled trial.

This systematic review examines the efficacy of a combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin in treating type 2 diabetes mellitus (T2DM) combined with heart failure (HF). Randomized controlled trials (RCTs) assessing the combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin for T2DM and CHF was conducted. The search, spanning from the database's establishment to June 2023, included seven databases: China Knowledge Network (CNKI), Wanfang Database, VIP Database, PubMed, Embase, Cochrane Library, and the Chinese Biomedical Literature Database. Two researchers screened and extracted data based on inclusion and exclusion criteria. The Cochrane Handbook version 5.1 guided the quality assessment of studies, and the meta-analysis was performed using RevMan 5.4 software. Eleven articles, encompassing a sample size of 1192 cases, were included. Meta-analysis results indicated that combining Qi benefiting and blood circulation promoting herbs with Dapagliflozin improved the clinical efficacy rate [OR=4.35, 95% CI (2.98, 6.35), P<0.00001]. It reduced blood glucose levels, evidenced by decreased fasting blood glucose (FBG) [MD=-1.19, 95% CI (-1.30, -1.09), P<0.00001], 2-hour postprandial blood glucose (2hPG) [MD=-1.95, 95% CI (-2.09, -1.80), P<0.00001], and glycosylated haemoglobin (HbA1c) [MD=-1.40, 95% CI (-1.49, -1.31), P<0.00001]. Inflammatory factors also reduced, including C-reactive protein (CRP) [MD=-4.93, 95% CI (-5.38, -4.48), P<0.00001], tumor necrosis factor (TNF-α) [MD=-2.91, 95% CI (-3.32, -2.49), P<0.00001], and interleukin-6 (IL-6) [MD=-11.10, 95% CI (-12.43, -9.43), P<0.00001]. Additionally, left ventricular end-diastolic diameter (LVEDD) [SMD=-1.25, 95% CI (-1.45, -1.05), P<0.00001], left ventricular end-systolic diameter (LVESD) [SMD=-1.34, 95% CI (-1.51, -1.13), P<0.00001], and improved left ventricular ejection fraction (LVEF)[SMD=2.92, 95% CI (2.65, 3.19), P<0.00001], 6-minute walk test (6MWT) [MD=35.59, 95% CI (29.72, 41.47), P<0.00001], and Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores [MD=35.59, 95% CI (29.72, 41.47), P<0.00001] were observed. The incidence of adverse events also decreased [RR=0.25, 95% CI (0.11, 0.56), P=0.0007]. The combination of Qi benefiting and blood circulation promoting herbs with Dapagliflozin shows potential in treating patients with T2DM and HF, suggesting its use as adjunctive therapy in clinical practice. However, the limited number and quality of the included studies necessitate further high-quality research to confirm these findings.

Associations Between Habit and Its Determinants with Medication Adherence in Chilean Patients with Type 2 Diabetes Mellitus

High rates of medication non-adherence have been reported in Chilean patients with type 2 diabetes mellitus (T2DM). Although habit is relevant to medication adherence, few studies have examined the antecedents of habit strength in taking diabetes medication. The aim of the present study was to assess the mediating role of habit strength in the association between determinants of habit formation and medication adherence in Chilean patients with T2DM. Participants were 245 T2DM patients from Chile. Variables were measured using self-report scales. Hypotheses were tested using a series of mediation models. Results supported the mediating role of habit strength in the relationships of medication adherence with planning, exposure to contextual cues, behavior repetition, perceived benefits, and intrinsic motivation. The theoretical and practical implications of these findings for the treatment of T2DM are discussed.

A very rare cause of markedly elevated CA 19–9: Glucagon-like peptide-1 receptor agonists

AimGlucagon-like peptide-1 (GLP-1) receptor agonists (GLP1-RAs) are commonly used to treat type 2 diabetes mellitus (T2DM). Various adverse reactions have been gradually reported. This case presents a rare phenomenon in which a GLP1-RA caused a marked elevation in carbohydrate antigen 19–9(CA 19–9) without evidence of a tumor. MethodsA mixed-methods approach was utilized, incorporating medical history obtained from regular outpatient consultations and follow-up visits, along with ancillary examinations derived from laboratory tests and imaging. ResultsThe use of a GLP1-RA for treating T2DM resulted in an increase in CA 19–9 without evidence of a tumor, which gradually normalized after discontinuation of the drug. ConclusionGLP1-RAs may lead to elevated levels of tumor markers during the treatment of T2DM, necessitating monitoring during therapy. Antidiabetic management should be adjusted on an individual basis as needed.

Exploring Holy Basil's Bioactive Compounds for T2DM Treatment: Docking and Molecular Dynamics Simulations with Human Omentin-1.

Type 2 Diabetes Mellitus (T2DM) presents a substantial health concern on a global scale, driving the search for innovative therapeutic strategies. Phytochemicals from medicinal plants, particularly Ocimum tenuiflorum (Holy Basil), have garnered attention for their potential in T2DM management. The increased focus on plant-based treatments stems from their perceived safety profile, lower risk of adverse effects, and the diverse range of bioactive molecules they offer, which can target multiple pathways involved in T2DM. Computational techniques explored the binding interactions between O. tenuiflorum phytochemicals and Human Omentin-1, a potential T2DM target. ADMET evaluation and targeted docking identified lead compounds: Luteolin (-4.84 kcal/mol), Madecassic acid (-4.12 kcal/mol), Ursolic acid (-5.91 kcal/mol), Stenocereol (-5.59 kcal/mol), and Apigenin (-4.64 kcal/mol), to have a better binding affinity to target protein compared to the control drug, Metformin (-2.01 kcal/mol). Subsequent molecular dynamics simulations evaluated the stability of Stenocereol, Luteolin, and Metformin complexes for 200 nanoseconds, analysing RMSD, RMSF, RG, SASA, PCA, FEL, and MM-PBSA parameters. Results indicated Stenocereol's strong binding affinity with Omentin-1, suggesting its potential as a potent therapeutic agent for T2DM management. These findings lay the groundwork for further experimental validation and drug discovery endeavours.

Do poor psychosocial resources mediate health inequalities in type 2 diabetes mellitus? Findings from the Maastricht study.

Low socioeconomic position (SEP) has been identified as a risk factor for type 2 diabetes mellitus (T2DM), and psychosocial resources might be on the pathway in this association. We examined two poor psychosocial resources, low control beliefs and inferiority beliefs, that might link low SEP with T2DM. 8292 participants aged 40-75 living in Southern Netherlands participated in The Maastricht Study starting from September 2010 to October 2020 and were followed up to 10 years with annual questionnaires. SEP (education, income, occupation), low control beliefs, inferiority beliefs, and (pre)diabetes by oral glucose tolerance test were measured at baseline. Incident T2DM was self-reported per annum. We analysed the mediating roles of poor psychosocial resources by using counterfactual mediation analysis. People with low SEP had more often prevalent and incident T2DM (e.g. low education: HR = 2.13, 95%CI: 1.53-2.97). Low control beliefs and high inferiority beliefs were more common among people with low SEP. Moreover, low control beliefs and high inferiority beliefs were risk factors for T2DM (e.g. low control beliefs: HR = 1.50, 95%CI: 1.08-2.09). The relationship between SEP and T2DM was partially mediated by control beliefs (8.0-13.6%) and inferiority beliefs (2.2-4.5%). We conclude that poor psychosocial resources are important in socioeconomic inequalities in diabetes. Researchers and practitioners should consider the psychosocial profile of people with lower SEP, as such a profile might interfere with the development, treatment, and prevention of T2DM. Further research should explore how poor psychosocial resources interact with chronic stress in relation to socioeconomic health inequalities.

Development of a high-yield recombinant clone for the enhanced production of a long-acting Glucagon like peptide-1 analogue with improved biological efficacy

Glucagon-like peptide-1 (GLP-1) analogues have demonstrated greater efficacy and safety in treating type 2 diabetes mellitus (T2DM) due to their strong ability to regulate hypoglycemia. The short plasma half-life of native GLP-1 has prompted the development of novel strategies, such as the conjugation of a C-16 fatty acid to lysine in the GLP-1 analogue sequence, to enhance its longevity. With the escalating burden of T2DM, there is a pressing need for the development of innovative GLP-1 analogues with enhanced efficacy and increased production capacities. In this study, we engineered three recombinant DNA-based clones by incorporating distinct upstream fusion tags, enzyme cleavage sites, and charge-based additional amino acid sequences. These constructed plasmids were subsequently transformed into E. coli BL21 DE3 hosts to enhance solubility and streamline downstream protein purification and were evaluated for yield, purity, and biological effectiveness. A high-yield clone was selected, and the peptide was purified using column chromatography, yielding 150–180 mg per Liter of fermentation culture. The purified C-16 fatty acid-conjugated GLP-1 analogue peptide was analysed for its biological activity, particularly cAMP generation in pancreatic β-cells. Results revealed a concentration of 10.58 pmol/mL of generated cAMP and an average 1.5-fold up-regulation of genes in the cAMP downstream pathway compared to the innovator standard. Based on these findings, we conclude that the developed clone, featuring the enterokinase cleavage site with a sequence of modified TrxA tag with five additional hydrophobic amino acids, not only enhances yield but also preserves the biological efficacy of the final product.

Identification and validation of diagnostic genes associated with neutrophil extracellular traps of type 2 diabetes mellitus.

Neutrophil extracellular traps (NETs) cause delayed wound closed up in type 2 diabetes mellitus (T2DM), but the specific regulatory mechanism of NETs-related genes (NETs-RGs) in T2DM is unclear. We acquired GSE21321 and GSE15932 datasets from gene expression omnibus (GEO) database. First, differentially expressed genes (DEGs) between T2DM and control samples of GSE21321 dataset were sifted out by differential expression analysis. NETs scores were calculated for all samples in GSE21321 dataset, and key module genes associated with NETs scores were screened by constructing co-expression network. Then, DEGs and key module genes were intersected to yield intersection genes, and candidate genes were identified by constructing a protein protein interaction (PPI) network. Least absolute shrinkage and selection operator (LASSO) regression analysis was implemented on candidate genes to screen out diagnostic genes, and they were subjected to single sample gene set enrichment analysis (ssGSEA). Finally, immune characteristic analysis was carried out, and we constructed the gene-drug and transcription factor (TF)-miRNA-mRNA networks. Besides, we validated the expression of diagnostic genes by quantitative real-time polymerase chain reaction (qRT-PCR). In total, 23 candidate genes were gained by PPI analysis. The 5 diagnostic genes, namely, inter-trypsin inhibitor heavy chain 3 (ITIH3), fibroblast growth factor 1 (FGF1), neuron cell adhesion molecule (NRCAM), advanced glycosylation end-product-specific receptor (AGER), and calcium voltage-gated channel subunit alpha1 C (CACNA1C), were identified via LASSO analysis, and they were involved in carboxylic acid transport, axonogenesis, etc. M2 Macrophage, Monocyte, Natural killer (NK) cell, and Myeloid dendritic cells (DC) were remarkably different between T2DM and control samples. Diagnostic genes had the strongest and the most significant positive correlation with B cells. The gene-drug network included CACNA1C-Isradipine, CACNA1C-Benidipine and other relationship pairs. Totally 76 nodes and 44 edges constituted the TF-miRNA-mRNA network, including signal transducer and activator of transcription 1(STAT1) -hsa-miR-3170-AGER, CCCTC-binding factor (CTCF)-hsa-miR-455-5p-CACNA1C, etc. Moreover, qRT-PCR suggested that the expression trends of FGF1 and AGER were in keeping with the results of bioinformatic analysis. FGF1 and AGER were markedly regulated downwards in the T2DM group. Through bioinformatic analysis, we identified NETs-related diagnostic genes (ITIH3, FGF1, NRCAM, AGER, CACNA1C) in T2DM, and explored their mechanism of action from different aspects, providing new ideas for the studies related to diagnosis and treatment of T2DM.

Beneficial effect of oral semaglutide for type 2 diabetes mellitus in patients with metabolic dysfunction-associated steatotic liver disease: A prospective, multicentre, observational study.

To evaluate the efficacy and safety of oral semaglutide for type 2 diabetes mellitus (T2DM) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This was a single-arm, multicentre, prospective study. Among 80 consecutive patients with MASLD and T2DM who newly received oral semaglutide, 70 completed 48-week oral semaglutide treatment as scheduled and were included in an efficacy analysis. Dose adjustments of oral semaglutide were determined by each physician while monitoring efficacy and adverse events. Significant improvements in body weight, liver enzymes, lipid profile, and glycaemic control were found at 48 weeks compared with baseline values (all p < 0.01). Controlled attenuation parameter values significantly decreased from baseline to 48 weeks (p < 0.01). Changes in alanine aminotransferase concentrations (r = 0.37, p < 0.01) and controlled attenuation parameter values (r = 0.44, p < 0.01) were significantly correlated with changes in body weight. Liver fibrosis markers, such as type IV collagen 7S, Wisteria floribunda agglutinin-positive Mac-2-binding protein, fibrosis-4 index, and liver stiffness measurement, significantly decreased from baseline to 48 weeks (all p < 0.01). The most common adverse events were Grades 1-2 transient gastrointestinal symptoms, such as nausea (23 patients, 28.8%), dyspepsia (12, 15.0%) and appetite loss (4, 5.0%). Oral semaglutide treatment for T2DM in patients with MASLD leads to an improvement in liver steatosis and injury, surrogate markers of fibrosis, diabetic status, and lipid profile, and reduces body weight.

Study on Pharmacodynamic Substances and Quality Control of Jiuwei Jiangtang Oral Liquid Based on Network Pharmacology, Fingerprint and In Vitro Experiment

Objective: This study aims to explore the fingerprint and quality control index components of Jiuwei Jiangtang Oral Liquid (JWJT), known for its therapeutic effects on type 2 diabetes mellitus (T2DM). Methods: This study employed network pharmacology and molecular docking to screen the core components, core targets, and pathways of JWJT. Additionally, HPLC fingerprint was established for 12 batches of JWJT. 12 batches of JWJT were evaluated using stoichiometry and common peaks were determined following a similarity assessment. The effective substances were selected to verify the index components of JWJT through assessing their control over glucose consumption in insulin-resistant HepG2 cells and their α-glucosidase inhibitory activity. Results: Through network pharmacology and molecular docking analysis, puerarin, calycosin, ellagic acid, kaempferol-3-O-rutinoside, and kaempferol were identified as core components of JWJT for treating T2DM. Key targets such as AKT1, PIK3R1, INSR, TNF, and EGFR were implicated in regulating pathways including HIF-1, MAPK, and PI3K-Akt in T2DM treatment. The HPLC fingerprints of 12 batches of JWJT samples revealed 10 common peaks, with puerarin, calycosin, ellagic acid, and kaempferol-3-O-rutinoside specifically identified among 4 chromatographic peaks. Using chemical pattern recognition, samples were categorized into two groups, with puerarin, calycosin, and ellagic acid identified as differential markers. Verification through glucose consumption in insulin-resistant HepG2 cells and α-glucosidase inhibitory activity confirmed that puerarin, calycosin, and ellagic acid were active ingredients suitable as quality control indicators for JWJT. Conclusion: The JWJT fingerprint method established in this study is both simple and reproducible. The selected index components will serve as the basis for quality control of JWJT and introduce a novel approach for selecting and verifying quality index components of JWJT in T2DM treatment.

Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists: Exploring Their Impact on Diabetes, Obesity, and Cardiovascular Health Through a Comprehensive Literature Review.

Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a novel class of medications promising for treating type 2 diabetes mellitus (T2DM) and obesity-related conditions such as cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). This comprehensive literature review examines available research on these medications, focusing on their mechanisms of action, clinical effectiveness, safety profiles, and socioeconomic implications. A comprehensive search was performed using the PubMed, EMBASE, and Cochrane Library databases. Although initially developed for glucose management, these drugs have also demonstrated efficacy in promoting weight loss and reducing the risk of CVD. GLP-1-RAs function similarly to naturally occurring incretins. They stimulate insulin secretion in response to glucose levels, inhibit glucagon release, delay stomach emptying, and generate a sense of fullness via brain pathways. Head-to-head clinical studies have indicated that GLP-1-RAs outperform conventional antidiabetic medicines in terms of glycemic management and weight reduction. According to cardiovascular outcome studies, various drugs in this category have been found to reduce the frequency of severe adverse cardiovascular events. A common side effect is gastrointestinal toxicity, which can be mitigated by gradually increasing the dose. Personalized treatment is likely because the effectiveness, safety, and dose regimens of currently available GLP-1-RAs differ. GLP-1-RAs are a superior choice for patients with T2DM, especially those who already have CVD or require weight-control support. The high cost of these drugs creates hurdles to access and fair healthcare. Current research mainly focuses on increasing therapeutic uses and producing orally delivered medicines with greater potency and bioavailability. Integrating GLP-1-RAs into clinical practice can enhance patient outcomes and reduce the community burden of cardiometabolic disease.

Analysis of clinical study registration characteristics of traditional medicine for the treatment of type 2 diabetes mellitus based on the International Clinical Trials Registry Platform

Objective: To analyze clinical trials of traditional medicine (including Chinese herbal medicine and nonpharmacological therapies) for the treatment of type 2 diabetes mellitus (T2DM) registered in the International Clinical Trials Registry Platform (ICTRP), and accordingly to explore their clinical trial registration characteristics, development trend and intervention status, in an attempt to provide references for future research design, diagnosis and management of traditional Chinese medicine therapy for T2DM. Methods: The clinical trials related to Chinese herbal medicine and nonpharmacological therapies for treating T2DM were retrieved on the ICTRP online from the time of database construction to August 13, 2023, to analyze the time of registration, country and institution of the study, source of funding, type and design of the study, randomization and blinding methods, clinical staging, therapeutic measures, and main therapeutic effect indexes. Descriptive statistical analysis was performed using R4.3.0 and Excel software. Results: A total of 774 clinical trials for T2DM treatment were included, of which 127 were traditional herbal therapies and 647 were nonpharmacological therapies. The T2DM clinical trial registration institutions were distributed in 50 countries worldwide involving 15 clinical registration platforms, with the most registrations in Iran, China, and Australia, and the top 3 registration platforms were the Iranian Clinical Trial Registry, the Australian New Zealand Clinical Trials Registry, and the ICTRP. Universities (551, 71.19%) were the main funding sources. Intervention studies (750, 96.90%) were the primary study type, including randomized controlled trials (432, 56. 4%), and 225 studies mentioned the blinding method. A total of 530 (68.48%) with a sample size ≤100 were included. Study phases were predominantly phase 2 and phase 3 (108, 51.43%). The interventions of traditional medicine for T2DM were composed of Chinese herbal medicines (mainly ginseng and astragalus compound), nonpharmacological therapies (mainly exercise and diet therapies), and 2 or more comprehensive treatment regimes. According to the type of study design, the first 3 main therapeutic indexes were fasting blood glucose (286 times), glycated hemoglobin (282 times), and insulin resistance (120 times), and the top 3 secondary therapeutic indexes were body mass index (179 times), fasting blood glucose (175 times), and glycated hemoglobin (134 times). Conclusion: The study dissects the current status and trend of registration of clinical trials on traditional medicine for T2DM treatment. The number of trial registrations is on the rise year by year, and there are obvious geographical differences in the countries and platforms of registration. The trial design is mainly randomized controlled blind trials with a sample size of &lt;100, and the main interventions are nonpharmacological therapies. Correct and standardized registration of clinical trials and timely reporting of study results are greatly important to facilitate the implementation of clinical trials, reduce publication bias, provide high-level diagnostic and therapeutic bases for clinical practice guidelines, and develop effective treatment strategies. This study is expected to help other scholars, health care professionals, patients, and the public to understand the latest research trends and hotspots in this field and provide certain references and inspirations for the future research design and clinical practice of traditional Chinese medicine in the treatment of T2DM.

Role of Triglyceride-Glucose Index in Type 2 Diabetes Mellitus and Its Complications.

Insulin resistance (IR) is the major mechanism in the pathogenesis of type 2 diabetes mellitus (T2DM). Early identification of IR is of great significance for preventing the onset of T2DM and delaying the progression of the disease. Previous studies have shown that triglyceride-glucose (TyG) index can be used as an effective surrogate marker for IR. There is a significant correlation between TyG index and T2DM and its common complications. In addition, the predictive efficacy of TyG index is better than that of other IR surrogate indicators. TyG index may not only become an important marker to identify people at high risk of T2DM and its complications, but is also expected to become a strong predictor of the prognosis of these diseases. However, there are still some challenges in the widespread application of TyG index in clinical practice. In the future, more high-quality studies are needed to clarify the assessment methods of TyG index for the prognosis of T2DM and its complications. Further investigations of the relationship between TyG index and T2DM and its complications will be expected to provide new ideas and methods for the prevention and treatment of T2DM and its complications.

Attitude, Knowledge, and Practices Regarding Prediabetes in Saudi Arabia: A Cross-Sectional Study on Family Medicine Residents.

Background Individuals with prediabetes are at an increased risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular diseasesand mortality from any cause. The treatment and early detection of prediabetes and T2DM can aid in the prevention of future health complications. The aim of this research was to assess the attitude, knowledge, and practices of family medicine (FM) residents in Saudi Arabia regarding prediabetes. Methodology This is an online cross-sectional survey study that was conducted between March and May 2023. The study population consisted of family medicine residents who are currently practicing their profession in Saudi Arabia. Results A total of 101 family medicine residents participated in this study. The study participants showed a positive attitude towardprediabetes management with a mean score of 25.4 (standard deviation {SD}: 4.8) out of 30. The study participants showed a moderate level of knowledge regarding prediabetes management with a mean score of 7.0 (SD: 2.2) out of 12. The proportion of participants who were able to identify risk factors that might prompt them to screen for diabetes mellitus ranged from 47.5% (n = 48) to 96.0% (n = 97). The participants' agreement levels for questions that examined their attitude towardthe importance of prediabetes screening ranged from 73.3% (n = 74) to 90.1% (n = 91). The most commonly agreed upon barrier was the patient's lack of motivation (n = 80, 79.2%). The most commonly agreed upon interventions that facilitate management and treatment improvements of prediabetes were more resources for patient education and increased access to the diabetes prevention program (DPP), an evidence-based lifestyle change program (n = 80, 79.2%). A body mass index (BMI) of ≥35 kg/m2 was the most commonly reported factor that increases the likelihood of prescribing metformin for a patient with prediabetes. The most commonly agreed upon barrier to prescribing metformin for prediabetes patients was that patients do not like taking medications (n = 67, 66.3%). Conclusions The study participants demonstrated an average level of understanding and a positive attitude regarding the management of prediabetes. A significant percentage of the participants demonstrated comprehension of risk factors associated with diabetes, as well as appropriate screening methods, with fasting blood glucose tests being of particular interest. It is recommended to enhance prediabetes management through heightened awareness and education concerning screening methodologies and lifestyle modifications.

SGLT-2 Inhibitors: The Next-generation Treatment for Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) has become a worldwide concern in recent years, primarily in highly developed Western societies. T2DM causes systemic complications, such as atherosclerotic heart disease, ischemic stroke, peripheral artery disease, kidney failure, and diabetes-related maculopathy and retinopathy. The growing number of T2DM patients and the treatment of long-term T2DM-related complications pressurize and exhaust public healthcare systems. As a result, strategies for combating T2DM and developing novel drugs are critical global public health requirements. Aside from preventive measures, which are still the most effective way to prevent T2DM, novel and highly effective therapies are emerging. In the spotlight of next-generation T2DM treatment, sodium-glucose co-transporter 2 (SGLT-2) inhibitors are promoted as the most efficient perspective therapy. SGLT-2 inhibitors (SGLT2i) include phlorizin derivatives, such as canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. SGLT-2, along with SGLT-1, is a member of the SGLT family of proteins that play a role in glucose absorption via active transport mediated by Na+/K+ ATPase. SGLT-2 is only found in the kidney, specifically the proximal tubule, and is responsible for more than 90% glucose absorption. Inhibition of SGLT-2 reduces glucose absorption, and consequently increases urinary glucose excretion, decreasing blood glucose levels. Thus, the inhibition of SGLT-2 activity ultimately alleviates T2DM-related symptoms and prevents or delays systemic T2DM-associated chronic complications. This review aimed to provide a more detailed understanding of the effects of SGLT2i responsible for the acute improvement in blood glucose regulation, a prerequisite for T2DM-associated cardiovascular complications control.

Sucrose-derived porous carbon catalyzed lignin depolymerization to obtain a product with application in type 2 diabetes mellitus

As the most important phenolic biopolymer in nature, lignin shows promising application potentialities in various bioactivities in vivo and in vitro, mainly including antioxidant, anti-inflammatory, hypolipidemic, and antidiabetic control. In this work, several carbon-based solid acids were synthesized to catalyze the fragmentation of organosolv lignin (OL). The generated lignin fragments, with controllable molecular weight and functional groups, were further evaluated for their application in the prevention and treatment of type 2 diabetes mellitus (T2DM). The results suggested that the urea-doped catalyst (SUPC) showed a more excellent catalytic performance in producing diethyl ether insoluble lignin (DEIL) and diethyl ether soluble lignin (DESL). In addition, the lignin fragments have a good therapeutic effect on the cell model of T2DM. Compared with the insulin resistance model, DEIL obtained by catalytic depolymerization of OL with SUPC could improve the glucose consumption of insulin-resistant cells. Moreover, low-concentration samples (50 μg/mL) can promote glucose consumption (19.7 mM) more than the traditional drug rosiglitazone (17.5 mM). This work demonstrates the prospect of depolymerized lignin for the prevention and treatment of T2DM and provides a new application field for lignin degradation products.

The impact of metformin on mortality in patients with type 2 diabetes mellitus: a prospective cohort study.

Metformin, a widely used antihyperglycemic drug, has shown efficacy in treating type 2 diabetes mellitus (T2DM) and is associated with potential benefits beyond glycemic control. This study investigates the impact of metformin on mortality in T2DM patients using a prospective cohort design utilizing data from the National Health and Nutrition Examination Survey (NHANES). In NHANES 1999-2014, a total of 5813 representative participants aged 20 and above with T2DM were included in the analysis. We utilized Kaplan-Meier survival curves and multivariate Cox regression analysis to investigate the impact of metformin on both all-cause mortality and cause-specific mortality among patients with T2DM. Kaplan-Meier analysis showed a significant reduction in all-cause and cause-specific mortality in metformin users compared to non-users (p < 0.05). Multivariate Cox regression confirmed these findings, indicating that metformin use was associated with a 18% reduction in all-cause mortality (HR = 0.82, 95% CI = 0.73-0.92, p < 0.001) and 25% reduction in cardiovascular mortality (HR = 0.75, 95% CI = 0.60-0.94, p = 0.01). Our results suggest that metformin significantly reduces all-cause and cardiovascular mortality in T2DM patients, highlighting its potential benefits beyond glycemic control. These results contribute to the existing literature by providing robust evidence from a large prospective cohort study. However, further research is needed to validate these findings and elucidate the underlying mechanisms controlling the effects of metformin on mortality outcomes in individuals with T2DM.