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Type 2 Diabetes and Complications: From Diagnosis to Treatment
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Type 2 Diabetes and Complications: From Diagnosis to Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: 25 July 2024 | Viewed by 2052

Special Issue Editor

Dr. Matteo Monami

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Guest Editor
Division of Diabetology, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Via delle Oblate 4, 50141 Florence, Italy
Interests: type 2 diabetes; obesity; diabetic foot ulcer; cardiovascular disease; bariatric surgery; microvascular complications

Special Issue Information

Dear Colleagues,

In 2019, the World Health Organization (WHO) reported that diabetes was the direct cause of 1.5 million deaths and that 48% of all deaths due to diabetes occurred before the age of 70. Another 460,000 kidney disease deaths were caused by diabetes, and raised blood glucose was found to cause around 20% of cardiovascular deaths. Moreover, between 2000 and 2019, there was a 3% increase in age-standardized mortality rates from diabetes. In lower–middle-income countries, the mortality rate due to diabetes increased by 13%. By contrast, the probability of dying from any one of the four main noncommunicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases, or diabetes) between the ages of 30 and 70 decreased by 22% globally between 2000 and 2019.

To try and reverse this dramatic trend, actions capable of increasing an early diagnosis of diabetes and its complications, together with innovative treatment for ameliorating glycemic control and the prognosis of chronic diabetic complications, are needed.

This Special Issue aims to provide a comprehensive review on these topics by collecting papers from an expert panel of authors.

Dr. Matteo Monami
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com 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. Journal of Clinical Medicine 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 2600 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.

Keywords

  • type 2 diabetes
  • diabetic foot ulcer
  • cardiovascular disease
  • microvascular complications
  • glycemic control

Published Papers (3 papers)

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Research

11 pages, 670 KiB  
Article
Is Metformin Use Associated with a More Favorable COVID-19 Course in People with Diabetes?
by Giovanni Antonio Silverii, Carlo Fumagalli, Renzo Rozzini, Marta Milani, Edoardo Mannucci and Niccolò Marchionni
J. Clin. Med. 2024, 13(7), 1874; https://doi.org/10.3390/jcm13071874 - 24 Mar 2024
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Abstract
Background: Diabetes Mellitus (DM) has been associated with a higher Coronavirus disease-19 (COVID-19) mortality, both in hospitalized patients and in the general population. A possible beneficial effect of metformin on the prognosis of COVID-19 has been reported in some observational studies, whereas other [...] Read more.
Background: Diabetes Mellitus (DM) has been associated with a higher Coronavirus disease-19 (COVID-19) mortality, both in hospitalized patients and in the general population. A possible beneficial effect of metformin on the prognosis of COVID-19 has been reported in some observational studies, whereas other studies disagree. Methods: To investigate the possible effect of metformin on COVID-19 in-hospital mortality, we performed a retrospective study that included all SARS-CoV-2-positive patients with DM who were admitted to two Italian hospitals. In order to adjust for possible confounders accounting for the observed reduction of mortality in metformin users, we adopted the COVID-19 Mortality Risk Score (COVID-19 MRS) as a covariate. Results: Out of the 524 included patients, 33.4% died. A binomial logistic regression showed that metformin use was associated with a significant reduction in case fatality (OR 0.67 [0.45–0.98], p = 0.039), with no significant effect on the need for ventilation (OR 0.75 [0.5–1.11], p = 0.146). After adjusting for COVID-19 MRS, metformin did not retain a significant association with in-hospital mortality [OR 0.795 (0.495–1.277), p = 0.342]. Conclusions: A beneficial effect of metformin on COVID-19 was not proven after adjusting for confounding factors. The use of validated tools to stratify the risk for COVID-19 severe disease and death, such as COVID-19 MRS, may be useful to better explore the potential association of medications and comorbidities with COVID-19 prognosis. Full article
(This article belongs to the Special Issue Type 2 Diabetes and Complications: From Diagnosis to Treatment)
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12 pages, 253 KiB  
Article
Early Treatment of Acute Stage 0/1 Diabetic Charcot Foot Can Avoid Major Amputations at One Year
by Cristina Bittante, Valerio Cerasari, Ermanno Bellizzi, Raju Ahluwalia, Michela Di Venanzio, Laura Giurato, Aikaterini Andreadi, Alfonso Bellia, Luigi Uccioli, Davide Lauro and Marco Meloni
J. Clin. Med. 2024, 13(6), 1633; https://doi.org/10.3390/jcm13061633 - 13 Mar 2024
Viewed by 567
Abstract
Background: If unrecognized, Charcot neuro-osteoarthropathy (CNO) can be a devastating complication of diabetes. Methods: The aim of this retrospective study was to evaluate the outcomes in a cohort of diabetic patients diagnosed with active CNO managed in a tertiary level diabetic foot clinic [...] Read more.
Background: If unrecognized, Charcot neuro-osteoarthropathy (CNO) can be a devastating complication of diabetes. Methods: The aim of this retrospective study was to evaluate the outcomes in a cohort of diabetic patients diagnosed with active CNO managed in a tertiary level diabetic foot clinic (DFC). We included consecutive patients with active CNO, stage 0–1, according to the Eichenholtz–Shibata classification, who were referred from 1 January 2019 to 27 September 2022. Diagnosis of CNO was based on clinical signs and imaging (X-rays and magnetic resonance). All patients were completely offloaded by a total-contact cast (TCC) or removable knee-high device. Each patient was closely monitored monthly until CNO remission or another outcome. At 12 months of follow-up, the following outcomes were analyzed: remission, time to remission, major amputations (any above the ankle), and surgical indication. Results: Forty-three patients were included. The mean age was 57.6 ± 10.8 years; 65% were males and 88.4% had type 2 diabetes, with a mean duration of 20.6 ± 9.9 years. At baseline, 32.6% was affected by peripheral artery disease. Complete remission was recorded in 40/43 patients (93%), with a mean time to remission of 5.6 ± 1.5 months; major amputation and surgical indication occurred, respectively in 1/43 patients (2.3%) and 3/43 patients (7%). Conclusions: Early treatment of active Stage 0/1 CNO leads to high rates of remission and limb salvage. Full article
(This article belongs to the Special Issue Type 2 Diabetes and Complications: From Diagnosis to Treatment)
9 pages, 575 KiB  
Article
Higher Prevalence of Cancer in Patients with Diabetic Foot Syndrome
by Chiara Goretti, Alessandro Prete, Alex Brocchi, Elisabetta Iacopi, Letizia Pieruzzi and Alberto Piaggesi
J. Clin. Med. 2024, 13(5), 1448; https://doi.org/10.3390/jcm13051448 - 01 Mar 2024
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Abstract
Background: Diabetes mellitus (DM) is associated with a higher prevalence of many forms of cancer. Diabetic foot syndrome (DFS) is associated with higher risk of lower limb amputation and mortality not all explainable with a cardiovascular profile at greater risk compared with [...] Read more.
Background: Diabetes mellitus (DM) is associated with a higher prevalence of many forms of cancer. Diabetic foot syndrome (DFS) is associated with higher risk of lower limb amputation and mortality not all explainable with a cardiovascular profile at greater risk compared with DM patients without DFS. DFS could be associated with an increasing cancer incidence. To explore a possible link between DFS and cancer, comparing two cohorts of patients (DFS+ and DFS−) with a cohort of superimposable non-DM controls. Methods: We retrospectively analysed the databases of our department for all consecutive patients admitted between January 2019 and December 2021, selecting all DM pts, and sorting DFS+ pts, admitted for foot complications, from DFS− ones, admitted for other reasons. Cases of pancreatic cancer as well as cancer-related admissions were excluded. Patients were compared to non-DM patients admitted for non-oncological medical problems. The primary endpoint was to compare the prevalence of cancer among the groups, while the secondary endpoint was to look for predictors for cancer in the groups studied. Results: A cohort of 445 consecutive DM inpatients (222 DFS+ and 223 DFS−) and 255 controls were studied. Cancer prevalence in DFS+ group was significantly higher than in DFS− (p = 0.008) and controls (p = 0.031), while no differences were observed between DFS− and the controls. Univariate regression analysis showed a significant association between cancer and DFS (p = 0.007), age at admission (p ≤ 0.001), years of diabetes (p = 0.017) and haemoglobin concentration [Hb] (p = 0.030). In the multivariate regression analysis with DFS, age at admission and [Hb], only DFS (p = 0.021) and age at admission (p ≤ 0.001) persisted as independent factors associated with cancer. Conclusions: A higher prevalence of cancer in DFS+ patients than in DFS− patients and non-diabetic controls is reported. DFS and age can both be considered independent predictors of cancer in patients with DM. Full article
(This article belongs to the Special Issue Type 2 Diabetes and Complications: From Diagnosis to Treatment)
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