Background/Objectives: Type 2 diabetes mellitus (T2DM) is a multisystemic disease with overlapping metabolic, renal, and cardiovascular effects. Within the Diabetic@ project, which aims to characterize individuals with T2DM using real-world data extracted from electronic health records (EHRs), this substudy sought to develop a predictive model for two-year heart failure (HF) risk. Methods: Multicenter, retrospective study including T2DM individuals across eight Spanish hospitals (2013–2018). Data were extracted exclusively from EHRs’ unstructured free text using clinical natural language processing (cNLP) and mapped to SNOMED CT. At inclusion, individuals were categorized as having or not prevalent HF (pHF). Predictive modeling was performed in non-pHF to assess two-year risk of developing HF, termed incident HF (iHF). Logistic regression (LR), decision trees, random forest, and XGBoost were compared, selecting for accuracy and interpretability. Results: Of 588,756 individuals with T2DM, 84,197 (14.3%) had pHF. Among non-pHF, 353,371 (60%) were used for model development (90.7% training, 9.3% validation). iHF occurred in 13.6% of the training set and 11.4% of the validation set. Ischemic heart disease was present in 16.2% overall, 37.9% in pHF, and 12.6% in non-pHF. Glycosylated hemoglobin data was rarely reported (<15%). LR achieved the best performance (AUC-ROC 0.73) using 27 predictors. Reduced 12- and clinically refined 9-predictor models performed similarly, with the latter implemented in a web-based tool. Conclusions: Unstructured data from EHRs enabled development of a two-year HF risk model for individuals with T2DM, underscoring the potential of cNLP for risk stratification across the cardiovascular–renal–metabolic spectrum.

Abstract Background: Diabetes mellitus (DM) is a chronic illness with potentially fatal and debilitating consequences. Problems with glycemic management are a major issue that adds an added strain to public health services. Objectives: The purpose of this study is to evaluate the prevalence of poor glycemic control and its related variables among type 2 diabetes mellitus (T2DM) patients in southern Jordan. Methods: A cross-sectional study was carried out in the Prince Hashem bin Abdullah II Hospital in Jordan’s southernmost province. For the period April–July 2024, 516 individuals with T2D were enrolled. A structured questionnaire that had been pre-prepared was used to collect data. As an index of glycemic control, a glycated hemoglobin (HbA1c) 7% cut-off point was adopted. Results: Poor glycemic control was prevalent in 81.0% of T2DM individuals. Inadequate glycemic control was significantly worse in non-married patients and those with 10 or more years of diabetes duration, insulin treatment, dyslipidemia, neuropathy, cardiovascular illness, and glomerular filtration rate (GFR = 60 mL/min; [ P &lt; 0.05]). Moreover, dyslipidemia and insulin administration increased the likelihood of poor glycemic control (odds ratio [OR]: 2 and 5, respectively) ( P &lt; 0.05). Conclusions: Inadequate glycemic control was common among the current study participants. To prevent disease consequences and enhance the health of patients with diabetes, health care professionals should pay special attention to related risk factors such as dyslipidemia, neuropathy, cardiovascular disease (CVD), extended illness duration, and insulin usage.

This systematic review and meta-analysis synthesized evidence on health-related quality of life (HRQoL), estimated using the EuroQol EQ-5D instrument, among individuals with type 2 diabetes mellitus (T2DM) and its complications in South Asian countries. We conducted a systematic search of PubMed-Medline, Scopus, Embase, Cochrane Controlled Register of Trials (CENTRAL) and Google scholar for studies reporting EQ-5D utility and VAS scores among individual with type 2 diabetes mellitus (T2DM) in South Asian countries. Eligible studies underwent a comprehensive systematic review and quality assessment using established appraisal tools. Mean EQ-5D scores were pooled in meta-analysis employing a random-effects DerSimonian–Laird model, and subgroup analyses were performed to explore sources of heterogeneity among the included studies. Meta-Regression analysis was conducted to evaluate the associations of age and disease duration with EQ-5D utility scores. The reviews protocol was registered in PROSPERO to ensure methodological transparency and reduce the risk of bias. A total of 22 studies conducted in individual with T2DM from South Asia were included. The pooled mean EQ-5D utility score was 0.75 (95% CI: 0.65–0.85) and mean Eq. 5D VAS score was 65.17 (95% CI: 57.81–72.54), indicating moderate HRQoL. individuals with T2DM complications had significantly lower scores utility score of 0.58 than compared to 0.81 among those without complications. Pain/discomfort and anxiety/depression were the most frequently reported domain with problems (58% and 53% respectively). Subgroup analyses revealed lower HRQoL for females, those with longer diabetes duration, with no comorbidities and in certain countries. Pooled utility values for T2DM individuals provide valuable insights into their HRQoL and are essential for informing health economics research. The observed associations between age, disease duration, and utility scores underscore the dynamic challenges of HRQoL over time, emphasizing the importance of tailored, long-term management strategies for diabetes care.

Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder. Adropin, asprosin, and irisin, recognized for their metabolic roles, lack clear establishment in cardiovascular disease (CVD) risk and T2DM guidelines. This study aimed to investigate the relationships between serum levels of these biomarkers and CVD risk in healthy, prediabetic, and T2DM individuals. A total of 30 individuals with T2DM, 30 prediabetic subjects, and 29 healthy controls were included in the study. The Framingham Risk Score (FRS) was calculated for each participant. Anthropometric measurements and key biochemical parameters, including fasting blood glucose, HbA1c (glycated hemoglobin), and lipid profile, were recorded. Serum levels of adropin, asprosin, and irisin were quantified using enzyme-linked immunosorbent assay. No statistically significant differences were found in serum adropin, irisin, and asprosin levels across diabetes status groups (p > 0.05). Adropin levels were significantly higher in individuals with lower waist circumference (WC) and body mass index (BMI) (p = 0.029; p = 0.024). Low asprosin levels correlated with greater WC (p = 0.021). FRS correlated significantly with metabolic parameters (age, BMI, WC, blood pressure, glucose, HbA1c, TG (triglycerides), HDL (High-Density Lipoprotein), HOMA-IR (Homeostatic Model Assessment of Insulin Resistance)). While no direct significant relationship was observed between these biomarkers and FRS, a positive significant correlation was found among adropin, asprosin, and irisin levels across all groups. These findings should be interpreted as exploratory and hypothesis generating. To the best of our knowledge, this study is the first to evaluate the associations of adropin, asprosin, and irisin with CVD risk in healthy, prediabetic, and T2DM individuals using FRS. The findings indicate that, although these proteins may not serve as independent predictors of CVD risk, their positive inter-correlations likely reflect underlying subclinical metabolic processes, providing valuable insights for future risk assessment strategies.

PurposeResults from a few studies have been conflicting regarding whether iron deficiency affects HbA1c reliability, and the mechanisms by which iron might influence HbA1c are not fully understood. We aimed to compare the relationship between HbA1c and average glucose levels measured by continuous glucose monitoring, retrospectively, in iron-replete and iron-deplete states among non-anemic type 2 diabetes mellitus (T2DM) patients.MethodsWe compared the differences in HbA1c between iron-replete and iron-deplete groups using the Chi-square test for categorical data and the Mann-Whitney U test for continuous data. We also evaluated the correlation between HbA1c and mean plasma glucose for both iron-replete and iron-deplete individuals using Pearson’s correlation and linear regression.ResultsA total of 146 of the 213 participants screened had complete data and were included in the final analysis. 43 out of 146 (29.5%) had iron deficiency, and 103 were iron-replete. No significant difference was observed in HbA1c levels between iron-replete and iron-deplete individuals: 69 (51.0, 85.0) vs 62 (46.0, 83.0) mmol/mol, P = 0.291). There was a strong positive correlation between HbA1c and mean plasma glucose concentration for both iron-replete and iron-deplete individuals (Pearson Correlation coefficient: 0.88 (0.83–0.92) and 0.93 (0.88–0.98), respectively).ConclusionsHbA1c correlates well with mean blood glucose even in the iron-deplete state amongst non-anaemic T2DM individuals. However, larger studies are needed to confirm these findings, particularly at screening and diagnostic thresholds.

BackgroundGenetic factors play an important role in metabolic disease susceptibility. Apolipoproteins E (APOE) and A1 (APOA1) are key regulators of lipid metabolism and have been individually associated with dyslipidemia and type 2 diabetes mellitus (T2DM).ObjectiveThis study aimed to examine the individual and combined associations of APOE (rs429358, rs7412) and APOA1 (rs5069) gene polymorphisms with obesity and T2DM.MethodsA case–control study was conducted including 350 participants categorized into four groups: controls (n = 100), euglycemic obese individuals (n = 100), obese individuals with T2DM (n = 100), and non-obese individuals with T2DM (n = 50). Biochemical parameters, including lipid profiles and glycemic indices, were assessed. Genotyping was performed using TaqMan® SNP genotyping assays.ResultsMetabolic disturbances and dyslipidemia were observed across all patient groups, with the most pronounced abnormalities in obese individuals with T2DM. The APOE ε4 allele and ε4/ε4 genotype were significantly associated with obese T2DM compared with controls and euglycemic obese subjects. The APOA1 rs5069 A allele and AA genotype were associated with both obesity and T2DM. Spearman correlation analysis revealed a positive co-occurrence of APOE and APOA1 genotypes in euglycemic obese (ρ = 0.264, p = 0.008) and obese T2DM (ρ = 0.347, p < 0.001) groups, but not in non-obese T2DM individuals. However, in multivariate logistic regression models adjusted for age, sex, and BMI, the APOE × APOA1 interaction term did not reach statistical significance (p = 0.138).ConclusionAPOE ε4 and APOA1 rs5069 A alleles were independently associated with obesity-related T2DM. Although these variants demonstrated correlated distribution patterns in obese individuals, the formal gene–gene interaction on T2DM risk was not statistically significant after multivariable adjustment. These findings suggest that obesity may represent a metabolic context in which combined genetic associations are more evident, warranting further investigation in larger and well-powered cohorts.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40001-025-03829-0.

BackgroundCognitive decline is frequently reported in individuals with type 2 diabetes mellitus (T2DM), and working memory impairment represents a key feature of diabetes-related cognitive changes. Previous studies have primarily compared T2DM patients with healthy controls and have typically examined only a single working memory domain. The present study aimed to classify T2DM patients based on Mini-Mental State Examination (MMSE) scores and to examine verbal and visuospatial working memory performance under different cognitive load conditions in order to characterize the cross-sectional association between working memory and global cognitive status.MethodsBetween November 2023 and June 2024, T2DM patients were recruited from the Department of Endocrinology at the Affiliated Hospital of Yan’an University. Based on MMSE scores, participants were classified into a higher cognitive status group (T2DM-HC, n = 29, MMSE ≥ 27) and a lower cognitive status group (T2DM-LC, n = 25, MMSE 21–26). Working memory performance was assessed using verbal and visuospatial N-back tasks (0-back to 2-back). Reaction time and accuracy were recorded under all task conditions.ResultsCompared with the T2DM-HC group, the T2DM-LC group had a longer duration of diabetes, higher HbA1c levels, and a greater number of comorbidities (all p < 0.05). In both verbal and visuospatial N-back tasks, the T2DM-LC group exhibited significantly longer reaction times (all p < 0.01), and accuracy declined more markedly under high cognitive load (2-back) conditions (all p < 0.001). Partial correlation analyses indicated that MMSE scores were significantly associated only with 2-back accuracy in both verbal and visuospatial conditions (r = 0.461, p < 0.01; r = 0.659, p < 0.001). Hierarchical regression analyses showed that inclusion of verbal 2-back accuracy increased the explained variance by 18.9% (ΔR2 = 0.189), whereas inclusion of visuospatial 2-back accuracy increased the explained variance by 38.6% (ΔR2 = 0.386).ConclusionAt the cross-sectional level, verbal and visuospatial working memory performance was significantly associated with global cognitive status in patients with T2DM, with group differences most pronounced under high cognitive load conditions. In this sample, visuospatial 2-back performance demonstrated a numerically stronger association with global cognitive status. This finding is exploratory in nature and warrants further investigation in future studies.

To investigate the levels of the triglyceride-glucose (TyG) index and sex hormone-binding globulin (SHBG) in patients with type 2 diabetes mellitus (T2DM) with diabetic retinopathy (DR), and to explore their correlations with biochemical parameters and the homeostasis model assessment of insulin resistance (HOMA-IR) in DR patients. Patients with T2DM and healthy individuals were enrolled. Age and body mass index (BMI) of the participants were collected, TyG of the subjects was calculated using the formula, SHBG level of the subjects was detected, and blood biochemical indexes were measured at the same time. The changes of each index among the groups were statistically analyzed, and the relationship between TyG, SHBG, DR and each index was analyzed. A total of 150 patients with T2DM and 64 healthy individuals as normal controls (NC, 28 males and 36 females, mean age 54.49±10.10y) were enrolled following ophthalmic evaluation. Patients were categorized into non-DR group (42 males and 36 females, mean age 56.68±8.02y) and DR group (35 males and 37 females, mean age, 53.83±11.10y). TyG levels were significantly elevated in both non-DR (7.25±0.62) and DR groups (8.02±0.82) compared to controls (6.85±0.48), with the DR group demonstrating higher TyG values than the non-DR group (P<0.05). The level of SHBG (nmol/L) in DR group (25.05±14.06) was lower than that in control group (41.90±22.6) and non-DR group (36.27±20.00; P<0.05). TyG exhibited significant inverse correlations with SHBG (r=-0.455) and high density lipoprotein (HDL; r=-0.430) levels (P<0.05). It was positively correlated with BMI, fasting blood glucose (FBG), 2h postprandial blood glucose (PBG), fasting C-peptide (FCP), glycated hemoglobin A1c (HbA1c), HOMA-IR, total cholesterol (TC) and triglycerides (TG) (r=0.406, 0.768, 0.386, 0.393, 0.475, 0.250, 0.242, 0.888, respectively, P<0.05). SHBG was negatively correlated with BMI, FBG, FCP, HbA1c and TyG (r=-0.440, -0.304, -0.407, -0.209, -0.455, respectively, P<0.05), and positively correlated with age, TG and HDL (r=0.238, 0.034, 0.227, respectively, P<0.05). Further multiple regression analysis showed that SHBG was negatively correlated with TyG (P=0.006). Elevated TyG index, reduces SHBG levels, and their negative correlation in the DR group suggest potential roles of TyG and SHBG in the pathogenesis and progression of DR. Combined assessment of SHBG and TyG may provide valuable insights for DR prediction and diagnosis.

Diabetic kidney disease (DKD) is a major complication of Type 2 diabetes mellitus (T2DM). Early detection is critical to prevent renal function decline and improve outcomes, but conventional biomarkers (e.g., urinary albumin-to-creatinine ratio [UACR] and estimated glomerular filtration rate [eGFR]) have limited sensitivity for early-stage kidney damage. Urinary cystatin C (UcyC) is a protein marker of impaired tubular reabsorption and a promising biomarker for early tubulointerstitial injury in DKD. This study assessed the clinical utility of UcyC for early detection and staging of DKD and compared its diagnostic performance with that of serum cystatin C (CysC). This prospective study included 102 patients with T2DM who were enrolled at The People's Hospital of Chizhou, China, between May 2022 and October 2025. The participants were classified as having T2DM without kidney disease (T2DM without KD) or DKD based on UACR and eGFR. The DKD group was divided into early DKD (EDKD) and clinical DKD (CDKD). Demographic and laboratory data were obtained from the hospital's medical records. Multivariate logistic regression analyses independent risk factors of DKD. Correlation analysis and receiver operating characteristic (ROC) curve analyses assess diagnostic accuracy and disease staging effectiveness of DKD. Compared with T2DM individuals free of renal complications, DKD patients showed significantly elevated UcyC concentrations (p < 0.001), paralleling advancing kidney impairment severity. Logistic regression quantified > 350-fold higher DKD risk per 10-fold logUcyC increase. UcyC demonstrated strong positive correlation with UACR and inverse correlation with eGFR, reinforcing its utility for tracking disease progression. Notably, ROC analysis confirmed superior staging accuracy versus CysC (AUC 0.830 vs. 0.691) and enhanced sensitivity plus negative predictive value for early DKD detection. UcyC, a noninvasive and highly sensitive biomarker for renal injury, could be valuable for early screening, assessing risk levels, and potentially guiding treatment personalization in DKD. This may streamline diagnosis and help tailor management plans for patients with DKD.

PurposeThe syndemic of tuberculosis (TB) and type 2 diabetes mellitus (T2DM) presents a growing global health challenge, particularly in high-burden countries. T2DM is known to impair immune responses, increasing susceptibility to TB. However, the cytokine dynamics underlying this interaction remain unclear. This study aimed to explore the differences in ex vivo cytokine responses between individuals with and without T2DM following TB antigen stimulation.Patients and MethodsIn this cross-sectional study, we analyzed plasma samples from 110 individuals with T2DM and 38 without, collected as part of the TANDEM and INFECT cohort studies in Indonesia. Cytokine levels (IL-1β, IL-6, TNF-α, and IFN-γ) were measured using ELISA before and after TB antigen stimulation using the QuantiFERON-TB Gold assay. Demographic, clinical, and metabolic parameters were recorded. Statistical analyses included Mann–Whitney U-tests and Spearman correlation.ResultsPatients with DM showed a higher baseline levels of pro-inflammatory cytokines than non-DM individuals, particularly in IL-1β, IL-6 and TNF-α, suggesting a primed immune response even before TB antigen exposure. After TB antigen stimulation, no significant between-group differences were observed in cytokine levels. However, IL-1β showed a more pronounced median increase in T2DM (124 vs –54 pg/mL, p = 0.43), while IL-6, TNF-α, and IFN-γ changes were blunted in the T2DM group. Correlation analyses revealed that in T2DM individuals, IL-1β positively correlated with IL-6 and TNF-α both pre- and post-stimulation. IL-6 and IFN-γ showed significant associations with HbA1c and BMI in the non-DM group.ConclusionT2DM group exhibited altered immune patterns marked by heightened IL-1β response and disrupted regulation of IL-6, TNF-α, and IFN-γ, although no statistically significant cytokine differences were observed. These findings suggest an immune dysregulation in T2DM that may contribute to TB susceptibility, warranting further investigation using CD4/CD8-responsive assays in larger, more diverse populations.

Introduction: Glucagon-like peptide-1 (GLP-1) agonists are key components of type-2 diabetes mellitus (T2DM) treatment due to their role in improving insulin secretion, inhibiting glucagon release, promoting lipid metabolism, and enhancing satiety. Recent studies have highlighted the possible drawback that comes with intended weight loss: muscle loss. This study seeks to better understand the significance of this muscle loss in terms of strength, function, and total mass lost in T2DM individuals with comorbid obesity. Methods: A 20-week treatment trial will investigate lean mass changes with the administration of GLP-1 agonists in 3 T2DM cohorts: insulin-reliant, metformin-reliant, and prediabetic groups, and their respective controls. Overall health analysis will occur through metrics such as total mass, lean mass, grip strength, 31P-MRS, quality of life questionnaires, HbA1c, and lipid panel. Through these, a holistic view on GLP-1 effectiveness, its relationship to unintended lean mass loss, and its health implications as a whole can be gained. Results: A relatively linear relationship between severity of T2DM and/or greater BMI and lean mass lost – both proportionally and absolutely – is anticipated. Similarly, the greater the severity of T2DM the more significant the decrease in muscle strength and function is predicted. Inversely, the most significant improvements in terms of HbA1c and lipid panel will be in the greater severity T2DM cohorts. Overall quality of life and patient experience will increase noticeably across all three treatment groups with respect to controls with slightly less increases with more severe T2DM. Discussion: This study improves GLP-1 usage guidelines through an investigation of the treatment over different populations. It exhibits the first literature utilizing 31P-MRS to gain insight on muscle function decreases across diabetic patients undergoing GLP-1 therapy. Possible co-treatments may be recommended in future studies to limit the lean mass lost in already susceptible populations. Conclusion: In conclusion, GLP-1 agonists demonstrate significant effects on lean mass, muscle strength, muscle function, and diabetic biomarkers, with the severity of T2DM varying the extent of the effects. While quality of life improvements are noticeable, the impact of GLP-1 treatment on muscle dynamics highlights complex interplay between muscle preservation and intended weight loss.

Obesity is characterized by chronic inflammation of adipose tissue, which is associated with the development of concomitant diseases. Recent studies indicate that regulatory T cells (Tregs) may play an important role in the pathogenesis of insulin resistance and type 2 diabetes mellitus (T2DM). The aim of the study was to evaluate the effect of extracellular vesicles (EVs) secreted by visceral and subcutaneous adipose tissue (VAT and SAT) of obese patients with/without T2DM on the Treg population, including their secretion of interleukin-10. EVs were obtained after cultivation of VAT and SAT of obese patients with/without T2DM and non-obese individuals. Primary culture of CD4+CD25+ Tregs was obtained by differentiating naive peripheral blood CD4+ T cells of healthy donors. Real-time PCR was used to assess the mRNA level of the genes of interest, and ELISA was used to determine the concentration of interleukin-10 in the culture medium. Simultaneous increase in the IL10 gene mRNA level and decrease in interleukin-10 secretion by Tregs were demonstrated after cultivation in the presence of VAT EVs; in the presence of SAT EVs from obese patients, the level of interleukin-10 secretion was slightly increased. The expression level of IL10 gene in SAT of non-obese individuals was lower compared to VAT, however, in obese patients with T2DM it was increased and comparable to that in VAT. AT EVs can potentially influence the population of Tregs, changing their suppressive activity and secretion of interleukin-10.

Towards personalized diabetes management: Identifying stability for efficient care using primary care data

Background: The prevalence of Type 2 diabetes mellitus (T2DM) has significantly increased in Saudi Arabia, rising from 16.8% in 2018 to 28% in 2023. This study aimed to identify and quantify the key biochemical factors associated with T2DM patients in the Aljouf region by comparing a comprehensive panel of biomarkers between T2DM and healthy individuals and to identify key risk factors in the regional population. Materials and Methods: A cross-sectional study was conducted by enrolling 114 T2DM patients and 91 healthy controls recruited from tertiary care centers in the Aljouf region, Saudi Arabia. We analyzed lipid profiles, vitamin levels (B12 and D), liver profile, and renal function markers. Statistical analyses included independent t-test, Pearson’s correlation, and binary logistic regression to calculate the Odds Ratio (OR) with 95% confidence intervals (CI). Results: T2DM patients showed significantly altered metabolic profiles including elevated triglycerides (p = 0.041), LDL cholesterol (p = 0.017), and serum uric acid (p < 0.001) in addition to deficient levels of vitamin B12 (p < 0.001) and vitamin D (p < 0.001). In logistic regression analysis, hyperuricemia (OR = 4.85, 95% CI: 2.45–9.61) and vitamin D deficiency (OR = 3.62, 95% CI: 1.98–6.62) were the strongest independent predictors of T2DM, after adjusting for potential confounders. Conclusions: Our findings confirm a distinct biochemical phenotype in T2DM patients from the Aljouf region. The potent associations of hyperuricemia and vitamin D deficiency with T2DM suggest their utility as key biomarkers providing a regional context. These findings highlight their potential relevance for prioritizing public health and clinical interventions in the studied population.

Monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1 (MIP-1) are two chemokines released by macrophages. The presence of these chemokines facilitates the recruitment of cells to regions marked by bone resorption and inflammation. Despite extensive research on these people in inflammatory contexts, there is no definitive evidence linking these chemokines to metabolic illnesses such as type 2 diabetes mellitus (T2DM) or any other metabolic condition. Research suggests that the pineal gland's hormone melatonin, which is formed from serotonin, may impact metabolic and inflammatory pathways. This is in addition to inflammatory chemicals. Melatonin, MCP-1, and MIP-1 have not been linked to metabolic diseases in their anticipated roles. Melatonin, MIP-1, and MCP-1 concentrations in T2DM patients were correlated with noteworthy cardiometabolic risk variables; this was the aim of the study. This study compared 83 healthy controls with 83 people who had T2DM using biochemical, anthropometric, and blood pressure measurements. This prospective, comparative, observational study was conducted over a 6-month recruitment period. The Department of Medicine at Index Medical College and Research Institute in Indore, India, enlisted volunteers throughout a 6-month period. The investigation involved two groups: individuals diagnosed with T2DM and healthy individuals of the same age. Descriptive statistics and correlation analyses were performed using Pearson's for parametric distributions. The groups were compared using the unpaired Student's t-test. Multiple regression was used to predict the blood levels of MIP-1, MCP-1, and melatonin. Statistical significance was considered at P < 0.05. Blood concentrations of MIP-1 and MCP-1 were higher in both controls and nontype 2 diabetic patients; however, melatonin levels in T2DM patients stayed the same. Triacylglycerol, diastolic blood pressure, and body mass index all showed positive correlations with MCP-1 concentrations. We observed an inverse relationship between MCP-1 levels and melatonin and high-density lipoproteins levels. Postprandial glucose levels were positively correlated with MCP-1 in T2DM patients. No cardiometabolic risk variables were significantly associated with melatonin levels in this population. There was a statistically significant relationship between population mean body mass and MCP-1 concentration (P = 0.001, adjusted R2 = 18.7%) as determined by multiple regression analysis. According to the findings, MCP-1 is present before T2DM metabolic problem. As a possible pathological biomarker for T2DM and its consequences, studying MCP-1 levels is essential.

Background/Objectives: A significantly higher fracture risk characterizes Type 2 diabetes mellitus (T2DM) patients when compared to the non-diabetic population, even though their average bone mineral density (BMD) tends to be normal or high. This elevated risk is primarily driven by defective bone quality. The trabecular bone score (TBS) and radiofrequency echographic multispectrometry (REMS) have recently been proposed to improve the assessment of bone quality in T2DM individuals. This study aimed to evaluate whether TBS and REMS can improve the identification of osteoporosis and fracture risk in these patients. Methods: BMD was measured in 223 consecutive T2DM patients (126 women and 97 man) and 102 controls. BMD values for the lumbar spine (LS), femoral neck (FN), and total hip (TH) were obtained via both dual-energy X-ray absorptiometry (DXA) and radiofrequency echographic multi-spectrometry (REMS). In all patients, TBS and Fragility Score (FS) by REMS were measured and prior major osteoporotic fractures (MOF) were assessed. Results: All BMD T-scores measured by REMS were significantly lower than those obtained by DXA at both lumbar and femoral sites. T2DM patients with previous MOF exhibited lower T-scores for both BMD-LS and BMD-TH, as assessed by DXA and REMS, compared with patients without fractures. However, these differences reached statistical significance for BMD-TH with both techniques and for BMD-LS with REMS, but not for BMD-LS with DXA. Moreover, patients with a history of MOF had significantly lower TBS values (p < 0.05) and significantly higher FS values at both lumbar (p < 0.05) and femoral (p < 0.01) sites compared with those without fractures. Conclusions: The results of this study suggest that the parameters obtained using REMS technology (BMD and FS) may be valuable tools for improving the diagnosis of osteoporosis and assessing fracture risk in patients with T2DM.

AimThe triglyceride-glucose (TyG) index, a surrogate marker reflecting metabolic status related to both glucose and lipid homeostasis, has been implicated in the development of diabetes-related complications, including diabetic kidney disease (DKD). Metabolic disturbances in carbohydrate and lipid pathways have also been linked to impairments in cognitive performance. This study aims to explore the association between TyG levels and the presence of mild cognitive impairment (MCI) among individuals with type 2 diabetes mellitus (T2DM), stratified by DKD status.MethodsA total of 243 patients with T2DM were divided into two subgroups based on cognitive status: those with MCI and those without. Clinical parameters were assessed and compared between the two cohorts. The association between TyG index and cognitive function was analyzed. Furthermore, potential predictors of MCI were explored separately in T2DM patients with and without DKD.ResultsIn individuals with T2DM, those exhibiting MCI (n = 95) showed significantly higher TyG index values in comparison to counterparts with normal cognition (n = 148). Elevated TyG index was linked to reduced performance on the Montreal Cognitive Assessment, a measure of global cognition, as well as diminished scores on both the Verbal Fluency Test and the delayed recall component of the Auditory Verbal Learning Test, which assess executive function and immediate memory, respectively, in patients without DKD. These findings suggest that heightened TyG index may serve as an independent risk indicator for cognitive decline in T2DM individuals without DKD. However, among those with coexisting DKD, no statistically meaningful association between TyG index and cognitive outcomes was observed.ConclusionElevated TyG index levels have been linked to an increased likelihood of MCI, particularly affecting executive function and immediate recall, among individuals with T2DM but without DKD.

Abstract Type 2 diabetes mellitus (T2DM) individuals are more prone to develop metabolic dysfunction associated steatotic liver disease (MASLD) as compared to normal individuals. It is important to diagnose MASLD early in T2DM individuals as it can progress to fibrosis and hepatocellular carcinoma if not detected early. In this review article, we look at the various imaging modalities available to diagnose MASLD and compare the merits and de merits of each imaging modality.

The association between the ZJU index and bone mineral density (BMD) among patients with type 2 diabetes mellitus☆

BackgroundChronic low back pain(CLBP) is the most prevalent musculoskeletal problem reported by individuals with Type 2 Diabetes Mellitus(T2DM). The effect of therapeutic intervention in this concomitant group of conditions has received limited scholarly attention.ObjectiveTo evaluate the effect of a comprehensive rehabilitation on pressure pain threshold(PPT), functional disability, and plantar pressure in T2DM individuals with CLBP.MethodsIn this study, 40 T2DM individuals with CLBP were included based on the pre-decided eligibility criteria. These participants received a comprehensive rehabilitation consisting of photobiomodulation, pain education, and exercise interventions for 12 weeks. The intervention's effect was evaluated on PPT, disability, and plantar pressure, which were assessed at baseline, the 12th week, and the 24th week. PPT was evaluated using an algometer. Oswestry disability index(ODI) and Win-Track system were used to assess disability and plantar pressure parameters, respectively.ResultsA statistically significant improvement over the time points was noted in PPT (F(1.72,67.07) = 117.9), ODI (F(1.49,58.19) = 119), maximal plantar pressure (F(1.62,63.09) = 33.01), and average plantar pressure (F(1.41,55.11) = 19.87). No significant difference was observed in contact area of bilateral feet across different timepoints.ConclusionA 12-week comprehensive rehabilitation program was effective in improving PPT, functional disability, and plantar pressure in T2DM individuals with CLBP.