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Potential Biomarkers and Promising Theranostics Approaches of Diabetes

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 6797

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Dr. Gulali Aktas

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Guest Editor

Department of Internal Medicine, Faculty of Medicine, Bolu Abant İzzet Baysal University, Bolu, Turkey
Interests: diabetes mellitus; diabetic kidney disease; diabetic retinopathy; diabetic neuropathy; diabetic foot ulcer; theranostics; treatment; diagnosis

Special Issue Information

Dear Colleagues,

Globally, Diabetes Mellitus (DM) is among the most common chronic diseases. Its incidence is increasing with an alarming velocity, despite the establishment of diabetes prevention programs. Both DM and its complications have deleterious effects on individual and global health. Moreover, patients with DM require increased health insurance expenses. Recent evidence suggest that the macrovascular and microvascular complications of DM have a great burden on healthcare systems. For this purpose, the early diagnosis and effective treatment of DM and its complications are among the issues that researchers focus on.

The effective prevention and treatment of a condition require the timely diagnosis of a disease or its complications. It is preferable that screening tests are reliable, easily accessible, widely available, and inexpensive. In this manner, many markers have been introduced that have associations with DM and its complications. However, there are currently a limited number of markers that could be classified as useful in clinical practice. Therefore, researchers in this field are still needed.

Theranostics refers to using one radioactive drug to establish the diagnosis and another radioactive drug to deliver therapy to treat cancer. On the other hand, theranostics approaches are also being studied in type 2 diabetes mellitus and in diabetic complications. The Special Issue entitled “Potential Biomarkers and Promising Theranostics Approaches of Diabetes” will encompass research articles, case reports, and literature reviews about novel biomarkers in the diagnosis of diabetic complications as well as innovative theranostics approaches both in the diagnosis and treatment of diabetes mellitus and its complications. The Special Issue will include but is not limited to: novel biomarkers of diabetes mellitus and its complications, especially diabetic kidney disease, diabetic foot ulcers, retinopathy, and neuropathy; theranostics approaches in the diagnosing and treating of diabetes-related conditions; and advancements in biomedical sciences regarding theranostics approaches in diabetic populations.

We eagerly await your valuable contributions.

Dr. Gulali Aktas
Guest Editor

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Keywords

diabetes mellitus
diabetic kidney disease
diabetic retinopathy
diabetic neuropathy
diabetic foot ulcer
theranostics
treatment
diagnosis

Published Papers (6 papers)

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Research

15 pages, 1794 KiB

Open AccessArticle

Homeostasis Model Assessment for Insulin Resistance Mediates the Positive Association of Triglycerides with Diabetes

by Yutang Wang, Yan Fang and Michal Vrablik

Diagnostics 2024, 14(7), 733; https://doi.org/10.3390/diagnostics14070733 - 29 Mar 2024

Viewed by 624

Abstract

Elevated circulating triglyceride levels have been linked to an increased risk of diabetes, although the precise mechanisms remain unclear. This study aimed to investigate whether low-density lipoprotein (LDL) cholesterol, homeostatic model assessment (HOMA) for insulin resistance, and C-reactive protein (CRP) served as mediators in this association across a sample of 18,435 US adults. Mediation analysis was conducted using the PROCESS Version 4.3 Macro for SPSS. Simple mediation analysis revealed that all three potential mediators played a role in mediating the association. However, in parallel mediation analysis, where all three mediators were simultaneously included, HOMA for insulin resistance remained a significant mediator (indirect effect coefficient, 0.47; 95% confidence interval [CI], 0.43–0.52; p < 0.05) after adjusting for all tested confounding factors. Conversely, LDL cholesterol (indirect effect coefficient, −0.13; 95% CI, −0.31–0.05; p > 0.05) and C-reactive protein (indirect effect coefficient, 0.01; 95% CI, −0.003–0.02; p > 0.05) ceased to be significant mediators. HOMA for insulin resistance accounted for 49% of the association between triglycerides and diabetes. In conclusion, HOMA for insulin resistance was the dominant mediator underlying the association between triglycerides and diabetes. Therefore, reducing triglyceride levels may hold promise for improving insulin sensitivity in diabetic patients. Full article

(This article belongs to the Special Issue Potential Biomarkers and Promising Theranostics Approaches of Diabetes)

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10 pages, 512 KiB

Open AccessArticle

Changes in Soluble Serum CD81 Concentration during an Oral Glucose Tolerance Test in Patients with Diabetes Mellitus and Individuals with Normal Glucose Tolerance

by Seon Mee Kang, Jun Choul Lee and Bon Jeong Ku

Diagnostics 2023, 13(23), 3500; https://doi.org/10.3390/diagnostics13233500 - 21 Nov 2023

Viewed by 667

Abstract

Aim: Cluster of differentiation 81 (CD81) is a cell surface protein involved in cell development, activation, growth, and motility. Recent studies have suggested that CD81 is a marker of dedifferentiated β-cells under conditions of metabolic stress, such as progressive diabetes. However, the clinical significance of changes in soluble serum CD81 (sCD81) in diabetic individuals remains unknown. The aim of this study was to investigate whether serum sCD81 concentrations differ between subjects with diabetes and normal glucose tolerance (NGT), and whether sCD81 changes during a 75 g oral glucose tolerance test (OGTT). Materials and methods: We recruited 101 subjects who had completed an OGTT. According to the test results, the participants were divided into diabetes mellitus (DM) and NGT groups. Participants with prediabetes were excluded from the analysis. During the OGTT, sCD81 levels were measured at 0 and 120 min. We compared changes in sCD81 between the groups. Results: In the DM group, soluble sCD81 levels were significantly higher at baseline and 120 min in the OGTT compared with the normal group (0.59 (0.22–1.05) ng/mL vs. 0.25 (0.81–0.67) ng/mL, 0.55 (0.17–0.96) ng/mL vs. 0.21 (0.92–0.78) ng/mL, p = 0.006 and 0.029, respectively). The soluble sCD81 levels in the NGT group remained unchanged (p = 0.658), while those in the DM group were significantly decreased during the OGTT (p = 0.003). Conclusion: Soluble sCD81 levels were elevated in individuals with type 2 diabetes, such that changes in sCD81 were only observed during the OGTT in the DM group. Soluble sCD81 may have potential as a new diagnostic marker for type 2 diabetes. Full article

(This article belongs to the Special Issue Potential Biomarkers and Promising Theranostics Approaches of Diabetes)

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12 pages, 983 KiB

Open AccessArticle

Control Level of Type 2 Diabetes Mellitus in the Elderly Is Associated with Polypharmacy, Accompanied Comorbidities, and Various Increased Risks According to the Beers Criteria

by Burcin Meryem Atak Tel, Gulali Aktas, Satilmis Bilgin, Sumeyye Buse Baltaci and Tuba Taslamacioglu Duman

Diagnostics 2023, 13(22), 3433; https://doi.org/10.3390/diagnostics13223433 - 13 Nov 2023

Viewed by 1052

Abstract

Comorbidity rates in the geriatric population have increased because of rising life expectancy; thus, patients have had to use more medications. Type 2 diabetes mellitus, one of the most common diseases, may influence the number of drugs used in geriatric patients. The present study was designed to investigate the association between the level of type 2 DM and polypharmacy. Fifty patients with type 2 diabetes over the age of 65 were included according to the inclusion criteria; 23 were well-controlled and 27 had poorly controlled diabetes. The groups were similar in terms of age, sex, WBC, Hb, Plt, AST, ALT, serum creatinine, fasting glucose, and eGFR levels. Patients with HbA1c values above 7.5 were classified as poorly controlled diabetes patients, and those below were considered well-controlled diabetes patients and were evaluated for inappropriate medication use. The number of medications used daily by the cases (p < 0.001), the number of concomitant diseases (p = 0.001), and the number of increased risks according to the Beers Criteria (p = 0.02) were observed to be high in poorly controlled type 2 diabetes mellitus subjects. HbA1c levels were related to the number of medications (r = 0.4, p = 0.004), comorbidities (r = 0.28, p = 0.04), and the number of increased risks according to the Beers Criteria (r = 0.31, p = 0.014). In conclusion, the number of medications used in patients with poorly controlled type 2 diabetes mellitus was found to be more elevated than in individuals with well-controlled type 2 diabetes mellitus. The HbA1c values varied among patients regarding polypharmacy, comorbidities, and increased risks according to the Beers Criteria. Full article

(This article belongs to the Special Issue Potential Biomarkers and Promising Theranostics Approaches of Diabetes)

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10 pages, 925 KiB

Open AccessArticle

Elevated Free Thyroxine Levels Might Alter the Effect of the Lipid Profile on Insulin Resistance in Type 2 Diabetes Mellitus

by Yi-Wei Lee, Ting-Teng Yang, Yan-Yu Lin and Yu-Shan Hsieh

Diagnostics 2023, 13(16), 2656; https://doi.org/10.3390/diagnostics13162656 - 11 Aug 2023

Cited by 1 | Viewed by 1016

Abstract

Previous studies have shown that hyperthyroidism is associated with heightened insulin resistance and dyslipidemia. Therefore, in this study, we aim to explore the relationship between elevated thyroid hormone levels and the lipid profile in insulin resistance in patients with type 2 diabetes mellitus (T2DM) with hyperthyroidism. A total of 177 participants were included and grouped according to diagnosis. The serum test results demonstrated that free thyroxine (FT4) increased the insulin resistance index (HOMA-IR) by positively correlating with triglyceride (TG) levels (p = 0.005, r² = 0.35). In patients with T2DM with hyperthyroidism, the decreasing high-density lipoprotein levels showed an association with HOMA-IR (p = 0.005). Among all the patients, with different levels of FT4, the areas under the ROC curve (AUCs) of the TG level, TG/high-density lipoprotein ratio, and HOMA-IR were 0.620 (95% CI: 0.536 to 0.698), 0.614 (95% CI: 0.530 to 0.692), and 0.722 (95% CI: 0.645 to 0.791), respectively. Our results suggest that elevated FT4 levels due to hyperthyroidism could alter the association with the lipid profile and insulin resistance in patients with T2DM. We also suggest that among all the included patients with T2DM, irrespective of the presence of hyperthyroidism, FT4 levels are positively correlated with insulin resistance. Full article

(This article belongs to the Special Issue Potential Biomarkers and Promising Theranostics Approaches of Diabetes)

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11 pages, 563 KiB

Open AccessArticle

Evaluation of Hepatic/Renal and Splenic/Renal Echointensity Ratio Using Ultrasonography in Diabetic Nephropathy

by Melike Elif Kalfaoglu

Diagnostics 2023, 13(14), 2401; https://doi.org/10.3390/diagnostics13142401 - 18 Jul 2023

Viewed by 1439

Abstract

The objective of this study is to assess the hepatic/renal and splenic/renal echointensity ratios in ultrasonography in patients with and without diabetic nephropathy. This retrospective study included patients with diabetes mellitus who underwent ultrasound examinations at our hospital between January 2023 and May 2023. Ultrasound examinations were conducted using renal cortical echogenicity and corticomedullary differentiation by using B-mode ultrasonography. The hepatic/renal and splenic/renal echo intensity ratios were compared among study groups (diabetic patients with diabetic nephropathy and without nephropathy). The diabetic nephropathy group exhibited significantly higher right renal echointensity and left renal echointensity compared to the non-nephropathic group. Additionally, the splenic/renal echointensity ratio and hepatic/renal echointensity ratio were significantly lower in the diabetic nephropathy group. Urinary microalbumin levels were significantly correlated with right renal echointensity (r = 0.65, p < 0.001) and left renal echointensity (r = 0.69, p < 0.001). There was also a significant inverse correlation between the urinary albumin and splenic/renal echointensity ratio (r = −0.58, p < 0.001). Ultrasonography, specifically the assessment of hepatic/renal and splenic/renal echointensity ratios, shows promise as a noninvasive and cost-effective method for evaluating morphological changes in the kidneys in patients with diabetic nephropathy. These findings suggest that ultrasonography can be a valuable tool for monitoring the progression of diabetic nephropathy and contributing to its early detection and management. Full article

(This article belongs to the Special Issue Potential Biomarkers and Promising Theranostics Approaches of Diabetes)

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12 pages, 586 KiB

Open AccessArticle

Could Systemic Inflammatory Index Predict Diabetic Kidney Injury in Type 2 Diabetes Mellitus?

by Tuba Taslamacioglu Duman, Feyza Nihal Ozkul and Buse Balci

Diagnostics 2023, 13(12), 2063; https://doi.org/10.3390/diagnostics13122063 - 14 Jun 2023

Cited by 18 | Viewed by 1324

Abstract

Background: The systemic inflammatory index (SII) is a new inflammatory marker that has been the subject of various studies in diseases with chronic inflammation. Diabetic nephropathy is a disease associated with chronic inflammation. We aimed to evaluate the relationship between SII and diabetic nephropathy. Methods: Patients with diabetes who applied to our outpatient clinic were included in the study. Diabetic patients were divided into two groups: those with diabetic nephropathy and those without. In addition, healthy individuals who applied to our clinic for general check-ups during these dates were included as the control group. The SII values and other characteristics of the three study groups were compared. Results: The median SII value for those with DKI was 584 (178–4819); for those without DKI, it was 282 (64–618); and for the control group, it was 236 (77.5–617) (p < 0.001). SII was significantly and positively correlated with BMI, weight, blood glucose, HbA1c, CRP, and creatinine, and negatively correlated with the glomerular filtration rate (GFR) value. SII values higher than 336 have 75% sensitivity and 70% specificity in detecting DKI. Conclusion: The SII value can predict diabetic kidney injury in diabetics, and it can be used as an adjunctive diagnostic tool. Full article

(This article belongs to the Special Issue Potential Biomarkers and Promising Theranostics Approaches of Diabetes)

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