Current Diabetes Reviews - Current Issue

Clinical trials indicate that IDegLira is effective in treating type 2 diabetes mellitus (T2DM). This study aims to assess the efficacy and safety of IDegLira in T2DM comprehensively.

To identify relevant randomized controlled trials, we searched PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. Risk Ratios (RR) and 95% Confidence Intervals (CI) were calculated using the Mantel-Haenszel approach for dichotomous outcomes. Mean Difference (MD) and 95% CI calculated by the inverse variance approach were applied to continuous outcomes.

Twelve randomized controlled trials involving 7628 participants were included in this study. Compared with control groups, IDegLira has a significant hypoglycemic effect in reducing hemoglobin A1c (MD = −0.66; 95% CI [−0.85, −0.47]; p < 0.00001), fasting plasma glucose (MD = −0.90; 95% CI [−1.40, −0.41]; p = 0.0003), self-measured plasma glucose (MD = −0.82; 95% CI [−1.22, −0.42]; p < 0.0001) and achieving the hemoglobin A1c level of < 7.0% (RR = 1.66; 95% CI [1.44, 1.92]; p < 0.00001) or < 6.5% (RR = 2.13; 95% CI [1.76, 2.57]; p < 0.00001). IDegLira outperforms insulin in achieving the target of HbA1c < 7.0 or < 6.5% without hypoglycemia and weight gain. Besides, IDegLira did not increase the incidence of adverse events and serious adverse events.

In this section, IDegLira’s benefits on simultaneously achieving glycemic control, weight loss, and reduced hypoglycemia risk were summarized. The statistical results were carefully interpreted in conjunction with clinical concerns regarding T2DM complications, adverse effects, and cost-effectiveness differences. An expanded discussion was conducted on integrating individualized HbA1c goals as a dual endpoint, without increasing body weight or the risk of hypoglycemia. Finally, the limitations of the present study were indicated.

IDegLira exhibits a favorable glycemic control effect and acceptable adverse effects in T2DM. Superior performance in the target glycemic control, particularly suitable for T2DM patients who do not reach the target hemoglobin A1c and have comorbid CVD or obesity.

Preclinical Evaluation of Fisetin in the Management of Diabetic Foot Ulcer in Wistar Rats.

Diabetic foot ulcer (DFU) is a complication of diabetes mellitus, often leading to non-traumatic amputations and significantly impacting patient morbidity. Globally, the prevalence of DFU ranges from 9.1 to 26.1 million annually. A 2022 meta-analysis revealed that 6.3% of diabetic adults (33 million) are affected by DFUs. The current treatments primarily focus on topical treatments, neglecting the underlying metabolic conditions.

To investigate the wound healing efficacy of the phytoconstituent fisetin, administered orally, in managing DFU in diabetic neuropathic Wistar rats.

This study investigates the therapeutic potential of a phytoconstituent fisetin, in the management of wound healing in STZ-NAD induced diabetic animal model with surgically induced wounds after indication of neuropathy. Fisetin was administered orally at doses of 5, 10, and 15 mg/kg for 30 days following the induction of foot ulcers, Various parameters were measured, including blood glucose levels, HbA1c, lipid profile, pro-inflammatory cytokines, antioxidant activity, MDA, and histopathological analysis of wound healing.

Fisetin, particularly at 15 mg/kg, significantly modulates blood glucose level, HbA1c, lipid profile, and pro-inflammatory cytokines, further enhancing antioxidant activity, while reducing MDA, indicating a reduction in oxidative stress. Histopathological analysis demonstrated enhanced wound healing by increased fibroblast proliferation and collagen formation, as well as restoration of the epithelial layer. Fisetin also exhibited potential in enhancing re-epithelization, enhancing pro-angiogenic markers, diminishing inflammation, and reducing wound size.

Fisetin demonstrates promising potential in managing DFU by modulating metabolic conditions, reducing blood glucose, oxidative stress, and inflammation, and promoting wound healing. Future studies should focus on unraveling the detailed molecular pathways involved in fisetin's action, along with clinical trials to validate its efficacy in DFU patients.

Although insulin is essential for managing type 1 diabetes and is life-saving for patients with this condition, some individuals may intentionally reduce or omit insulin due to a fear of weight gain or a desire to lose weight. This behavior is commonly referred to as diabulimia.

Since diabulimia is not formally defined, a systematic review of the limited literature was conducted on November 8th, 2024, using PubMed, Scopus, and Web of Science databases. The search terms included “diabulimia”, “insulin omission”, “insulin restriction”, “eating disorders”, “disordered eating”, and “type 1 diabetes”. Out of 288 manuscripts, 19 were selected after excluding non-English articles and screening the titles and abstracts.

Eating disorders and disordered eating are common in patients with type 1 diabetes, often driven by concerns regarding body image and weight. These behaviors can complicate diabetes management, worsen glucose control, and increase the risk of complications. Diabulimia may develop as a coping mechanism, especially in adolescents with higher body mass index and a history of eating disorders. Diagnosis is challenging due to the lack of established guidelines, but poor glucose control can raise suspicion and prompt further psychological evaluation. A multidisciplinary approach, combining medical care, nutrition, mental health support, and therapy, is recommended, despite limited evidence.

While diabulimia is not formally recognized, understanding its impact can help healthcare professionals diagnose and manage it more effectively, improving patients’ health and well-being.

Type 2 Diabetes Mellitus (T2DM) is marked by insulin resistance and chronic hyperglycemia. Yoga, a complementary therapy, may improve metabolic outcomes when used with standard care. This systematic review and meta-analysis aimed to evaluate the effects of yoga on glycemic control, insulin resistance, oxidative stress, and psychological well-being in individuals with or at risk of T2DM.

We conducted a systematic search in PubMed, CAM-QUEST^®, and the Cochrane Central Register following PRISMA guidelines. We included randomized controlled trials (RCTs) assessing yoga interventions (asanas, pranayama, kriyas, and meditation) alongside standard care. Primary outcomes were fasting blood glucose (FBS), postprandial blood glucose (PPBS), HbA1c, serum insulin, and HOMA-IR. Secondary outcomes included oxidative stress markers (glutathione, malondialdehyde [MDA], superoxide dismutase [SOD]) and psychological outcomes. Meta-analyses were conducted using random-effects models in RevMan 5.4.1.

Fourteen RCTs (n = 1,629 participants) were included. Yoga combined with standard care significantly improved FBS (SMD = -1.60; 95% CI: -2.27 to -0.92), PPBS (SMD = -2.16; p = 0.03), HbA1c (SMD = -0.92; 95% CI: -1.59 to -0.26), and HOMA-IR (SMD = -1.28; p = 0.002). MDA levels were significantly reduced, though glutathione and SOD showed no significant changes. Psychological well-being improved in several trials.

Yoga appears effective in improving glycemic outcomes and insulin resistance in patients with or at risk of T2DM. It may also reduce oxidative stress and enhance psychological well-being, highlighting its potential as a holistic intervention.

Yoga, when integrated with standard care, offers clinically relevant benefits in managing T2DM and related metabolic risks. Further high-quality, multi-centered trials using standardized protocols are needed to validate and generalize these findings.

Epigenetic regulation constitutes critical molecular mechanisms underlying the pathogenesis of diabetes and disease progression. While substantial mechanistic investigations exist, the field lacks systematic mapping of research trends, collaborative networks, and emerging frontiers.

To conduct the first comprehensive bibliometric evaluation of epigenetic studies in diabetes mellitus and its complications (2014-2024), identifying key research domains, international collaboration patterns, and innovative investigative directions to inform strategic research planning and highlight opportunities for innovative therapeutic approaches.

We interrogated the Web of Science Core Collection using stringent inclusion criteria, analyzing 1,451 publications through advanced multi-dimensional metrics in CiteSpace (6.2.R4), VOSviewer (1.6.20), and Bibliometrix (4.1.3).

A total of 1,451 original and review articles were retrieved, involving 83 countries/regions, 576 journals, and 7,645 authors. The United States produced the highest number of publications (n = 464), followed by China (n = 283) and Italy (n = 121). The International Journal of Molecular Sciences was the leading journal (66 publications), dominated by review articles (n = 53). Author collaboration networks were extensive, with Charlotte Ling emerging as the most prolific and influential author in publications, citations, and H-index. Keyword co-occurrence analyses emphasized type 2 DM, gestational DM, and diabetic nephropathy as primary research focuses, while new frontiers highlighted potential links to Alzheimer’s disease and fibroblast biology.

This multi-dimensional analysis provides quantitative visualization of research evolution, delineates current investigative priorities, and highlights underexplored therapeutic targets. Our findings establish a strategic framework for transdisciplinary collaboration in precision diabetology.