Novel Insights in the Pathophysiology and Management of Diabetes-Related Complications

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 1868

Special Issue Editor

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Guest Editor
First Department of Propaedeutic Medicine, National Kapodistrian University of Athens, Laiko University Hospital, 11527 Athens, Greece
Interests: diabetes mellitus; obesity; non-alcoholic fatty liver disease (NAFLD); bariatric surgery; body composition; cardiovascular disease; insulin resistance; metabolically healthy obese; mitochondrial function
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Special Issue Information

Dear Colleagues,

Diabetes mellitus represents a complex multifactorial syndrome characterized by abnormalities in every single aspect of cellular energy metabolism. Over its natural course, it can be complicated by serious comorbidities which affect multiple organs and systems such as the cardiovascular, nervous and gastrointestinal systems, kidneys, skin, mental and psychological health and others. According to recent data from the International Diabetes Federation, an estimated 463 million adults are currently living with diabetes globally. If current trends continue, this number is projected to nearly double by the year 2030, making diabetes the contemporary metabolic pandemic. Type 1 diabetes mellitus (T1DM), associated with reduced endogenous insulin secretion as a result of autoimmune destruction of insulin-producing pancreatic β-cells, is currently experiencing an increase in its incidence, possibly due to the elevated childhood obesity rates. Type 2 diabetes mellitus (T2DM), associated with the combined presence of both insulin resistance and defective insulin secretion, makes up about 85-90% of all cases, and the alarming increase in its global prevalence relates to the aging population and the increasing rates of obesity and sedentary lifestyle. Diabetes-related multifaceted complications represent one of the leading causes of morbidity and mortality worldwide and limit diabetic patients’ life expectancy. Cardiorenal complications in particular are the leading cause of death among patients with diabetes.

Typical complications of T1DM and T2DM comprise microvascular complications such as retinopathy, nephropathy and neuropathy, and macrovascular complications including stroke, ischemic heart disease and peripheral artery disease. Beyond these classical vascular complications, diabetes has been further associated with a large number of other clinically relevant complications such as non-alcoholic fatty liver disease and especially non-alcoholic steatohepatitis (NASH), depression, cognitive impairment in the form of either vascular dementia or Alzheimer’s disease, hypoglycemia as a result of antidiabetic treatment, increased susceptibility to infections (including COVID-19 disease) and malignancies. These complications may significantly disrupt patients’ quality of life and pose a substantial burden for patients, societies and healthcare systems. The major pathophysiological mechanisms underlying diabetes-related complications involve insulin resistance, gluco- and lipotoxicity, accumulation of advanced glycation end products (AGEs), impaired mitochondrial function in several tissues, subclinical inflammation, oxidative stress, endothelial dysfunction and cellular senescence pathways.

This Special Issue invites the submission of original research and review articles related to any of the diabetes-related complications mentioned above, both in terms of pathophysiological mechanisms and current treatment approaches. The broad scope of this Special Issue reflects the broad spectrum of diabetes-related complications and gives a great opportunity to generate an updated article collection providing an overview of the most recent developments in understanding the major pathophysiological traits implicated in diabetes-related complications, and recent breakthroughs in treatment options for these potentially life-threatening diabetes-related health risks.

Dr. Chrysi Koliaki
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.


  • type 1 diabetes mellitus
  • type 2 diabetes mellitus
  • complications
  • microvascular complications
  • macrovascular complications
  • non-alcoholic steatohepatitis
  • cardiovascular disease
  • insulin resistance

Published Papers (1 paper)

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8 pages, 426 KiB  
Association of Hypoglycemia with Biomarkers of Oxidative Stress and Antioxidants: An Observational Study
by Eleftheria Papachristoforou, Aikaterini Kountouri, Eirini Maratou, Dimitris Kouretas, Zoi Skaperda, Maria Tsoumani, Panagiotis Efentakis, Ignatios Ikonomidis, Vaia Lambadiari and Konstantinos Makrilakis
Healthcare 2022, 10(8), 1509; - 10 Aug 2022
Cited by 2 | Viewed by 1375
Hypoglycemia has been associated with complications from the vasculature. The contributing effects of oxidative stress (OS) on these actions have not been sufficiently studied, especially in daily, routine clinical practice. We examined the association of hypoglycemia encountered in daily clinical practice with biomarkers [...] Read more.
Hypoglycemia has been associated with complications from the vasculature. The contributing effects of oxidative stress (OS) on these actions have not been sufficiently studied, especially in daily, routine clinical practice. We examined the association of hypoglycemia encountered in daily clinical practice with biomarkers of OS and endogenous antioxidant activity in persons with diabetes [type 1 (T1D) or type 2 (T2D)], as well as individuals without diabetes, with a history of hypoglycemia. Several biomarkers of OS (MDA, ADMA, ox-LDL, 3-NT, protein carbonyls, 4-HNE, TBARS) and antioxidant capacity (TAC, superoxide scavenging capacity, hydroxyl radical scavenging capacity, reducing power, ABTS) were measured. Blood was drawn at the time of hypoglycemia detection and under euglycemic conditions on a different day. A total of 31 participants (mean age [±SD] 52.2 ± 21.1 years, 45.2% males) were included in the study. There were 14 (45.2%) persons with T2D, 12 (38.7%) with T1D, and 5 (16.1%) without diabetes. We found no differences in the examined biomarkers. Only TBARS, a biomarker of lipid peroxidation, showed lower values during hypoglycemia (p = 0.005). This finding needs confirmation in more extensive studies, given that MDA, another biomarker of lipid peroxidation, was not affected. Our study suggests that hypoglycemia encountered in daily clinical practice does not affect OS. Full article
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