Diabetes Mellitus: Current Research and Future Perspectives

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (20 February 2024) | Viewed by 16384

Special Issue Editor

Pediatric Unit, S. Chiara Hospital, 38122 Trento, Italy
Interests: diabetology; pediatric endocrinology; nutrition; obesity; bone metabolism
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The heterogeneity in age at onset and clinical presentation within the same form of diabetes, differences in the response to treatments in patients with the same phenotype, as well as the variability in the course of the disease require personalized management. The precision medicine approach has been applied to individuals with monogenic diabetes (i.e., MODY, neonatal diabetes) and to type 1 and type 2 diabetes, to select treatments that are most likely to offer benefits and least likely to cause side effects, with improvement of clinical outcomes and economic cost saving.  

In the last 10 years, genetic, metabolomic, immunologic, and other sophisticated tests have become less expensive and more widespread; therefore, it is expected that precision medicine will become increasingly applied to diabetes care. 

This Special Issue of the Journal of Personalized Medicine aims to highlight the current state of precision medicine applied to diabetes, to show some of the latest findings and future perspectives, and to integrate expertise from basic science, clinical, and population-based approaches. Topics of interest include novel insights into gene testing, polymorphisms and bioinformatics, metabolites and intestinal microbiome analysis, as well as their association with the risk of disease, drug metabolism, or disease complications.

Dr. Roberto Franceschi
Guest Editor

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Keywords

  • diabetes treatment
  • drug metabolism
  • disease complications
  • polymorphisms
  • epigenetics
  • metabolomics
  • proteomics

Published Papers (7 papers)

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Editorial

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3 pages, 171 KiB  
Editorial
Special Issue—Diabetes Mellitus: Current Research and Future Perspectives
by Roberto Franceschi
J. Pers. Med. 2024, 14(3), 308; https://doi.org/10.3390/jpm14030308 - 15 Mar 2024
Viewed by 528
Abstract
The Special Issue “Diabetes Mellitus: Current Research and Future Perspectives” is focused on the importance of customized medicine in monogenic diabetes of the young (MODY) and type 2 diabetes (T2D) [...] Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
3 pages, 173 KiB  
Editorial
Precision Medicine in Diabetes, Current Research and Future Perspectives
by Roberto Franceschi
J. Pers. Med. 2022, 12(8), 1233; https://doi.org/10.3390/jpm12081233 - 28 Jul 2022
Cited by 5 | Viewed by 1843
Abstract
The prevalence of diabetes has tripled over the past 2 decades, and by 2050, it is estimated to affect 700 million adults [...] Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)

Research

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15 pages, 3063 KiB  
Article
Harnessing Code Interpreters for Enhanced Predictive Modeling: A Case Study on High-Density Lipoprotein Level Estimation in Romanian Diabetic Patients
by Maitham Abdallah Albajy, Maria Mernea, Alexandra Mihaila, Cristian-Emilian Pop and Dan Florin Mihăilescu
J. Pers. Med. 2023, 13(10), 1466; https://doi.org/10.3390/jpm13101466 - 06 Oct 2023
Viewed by 868
Abstract
Diabetes is a condition accompanied by the alteration of body parameters, including those related to lipids like triglyceride (TG), low-density lipoproteins (LDLs), and high-density lipoproteins (HDLs). The latter are grouped under the term dyslipidemia and are considered a risk factor for cardiovascular events. [...] Read more.
Diabetes is a condition accompanied by the alteration of body parameters, including those related to lipids like triglyceride (TG), low-density lipoproteins (LDLs), and high-density lipoproteins (HDLs). The latter are grouped under the term dyslipidemia and are considered a risk factor for cardiovascular events. In the present work, we analyzed the complex relationships between twelve parameters (disease status, age, sex, body mass index, systolic blood pressure, diastolic blood pressure, TG, HDL, LDL, glucose, HbA1c levels, and disease onset) of patients with diabetes from Romania. An initial prospective analysis showed that HDL is inversely correlated with most of the parameters; therefore, we further analyzed the dependence of HDLs on the other factors. The analysis was conducted with the Code Interpreter plugin of ChatGPT, which was used to build several models from which Random Forest performed best. The principal predictors of HDLs were TG, LDL, and HbA1c levels. Random Forest models were used to model all parameters, showing that blood pressure and HbA1c can be predicted based on the other parameters with the least error, while the less predictable parameters were TG and LDL levels. By conducting the present study using the ChatGPT Code Interpreter, we show that elaborate analysis methods are at hand and easy to apply by researchers with limited computational resources. The insight that can be gained from such an approach, such as what we obtained on HDL level predictors in diabetes, could be relevant for deriving novel management strategies and therapeutic approaches. Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
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11 pages, 1313 KiB  
Article
Genetic and Clinical Characterization of Patients with HNF1B-Related MODY in Croatia
by Maja Baretić, Domagoj Caban and Jadranka Sertić
J. Pers. Med. 2023, 13(7), 1063; https://doi.org/10.3390/jpm13071063 - 28 Jun 2023
Viewed by 948
Abstract
Background: Mutation of the gene encoding Hepatocyte Nuclear transcription Factor-1 Beta (HNF1B) causes a rare monogenetic subtype of Maturity-Onset Diabetes of the Young (MODY). HNF1B-related MODY results in the dysfunction of multiple organ systems. However, genetic analysis enables personalized medicine for patients and [...] Read more.
Background: Mutation of the gene encoding Hepatocyte Nuclear transcription Factor-1 Beta (HNF1B) causes a rare monogenetic subtype of Maturity-Onset Diabetes of the Young (MODY). HNF1B-related MODY results in the dysfunction of multiple organ systems. However, genetic analysis enables personalized medicine for patients and families. Aims: To understand the clinical characteristics and explore the gene mutations in Croatian patients. Methods: This was a retrospective observational study of individuals (and their relatives) who were, due to the clinical suspicion of MODY, referred to the Department of Laboratory Diagnostics at the University Hospital Centre Zagreb for genetic testing. Results: A total of 118 participants, 56% females, were screened. Seven patients (three females) from five families were identified to have HNF1B-related MODY. The median age at diagnosis was 31 (11–45) years, the median c-peptide was 0.8 (0.55–1.39) nmol/L, the median HbA1c was 9.1 (5.7–18.4)%, and the median BMI was 22.9 kg/m2 (17–24.6). Patients had a variety of clinical manifestations; kidney disease was not as frequent as liver lesions, neuropsychiatric symptoms, hyperlipidemia, hyperuricemia, and hypomagnesemia. We identified two new pathogenic mutations (c.1006C > G protein p.His336Asp on exon 4 and c.1373T > G p protein Val458Gly on exon 7). Conclusions: In a study involving Croatian patients, new genetic (two previously unknown mutations) and clinical (diverse range of clinical presentations) aspects of HNF1B-related MODY were found. Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
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14 pages, 498 KiB  
Article
The Correlation between Metformin Use and Incident Dementia in Patients with New-Onset Diabetes Mellitus: A Population-Based Study
by Kuang-Hua Huang, Ya-Fang Tsai, Chiachi Bonnie Lee, Shuo-Yan Gau, Tung-Han Tsai, Ning-Jen Chung and Chien-Ying Lee
J. Pers. Med. 2023, 13(5), 738; https://doi.org/10.3390/jpm13050738 - 26 Apr 2023
Cited by 3 | Viewed by 7397
Abstract
The evidence of metformin’s effect on dementia is conflicting. This study investigates the association between metformin use and the risk of dementia among patients with diabetes mellitus (DM). This study included patients with new-onset DM between 2002 and 2013. We divided the patients [...] Read more.
The evidence of metformin’s effect on dementia is conflicting. This study investigates the association between metformin use and the risk of dementia among patients with diabetes mellitus (DM). This study included patients with new-onset DM between 2002 and 2013. We divided the patients into patients who used metformin and patients who did not. Two models were used to assess metformin use: the cumulative defined daily dose (cDDD) of metformin use and the intensity of metformin use. This study with 3-year and 5-year follow-ups investigated the risk of dementia among patients with DM who used metformin. At the 3-year follow-up, patients who received cDDD < 300 had an odds ratio (OR) of developing dementia of 0.92 (95% confidence interval [CI] = 0.89–0.96); patients who used metformin at intensities <10 and 10–25 DDD/month had ORs of 0.92 (95% CI: 0.87–0.97) and 0.92 (95% CI: 0.85–1.00), respectively. Metformin use at cDDD 300–500 (OR = 0.80, 95% CI = 0.56–1.15) or >500 (OR = 1.48, 95% CI = 0.48–4.60) or at an intensity >25 DDD/month (OR = 0.84, 95% CI = 0.60–1.18) were not associated with an incident of dementia. There were similar results at the 5-year follow-up. Patients with a low intensity of metformin use had a lower risk of dementia. However, higher doses of metformin with higher intensity exhibited no protective role in dementia. Prospective clinical trials are warranted to evaluate the actual underlying mechanisms between metformin dosage and the risk of dementia. Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
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12 pages, 985 KiB  
Article
Prevalence of Cognitive Decline in Type 2 Diabetes Mellitus Patients: A Real-World Cross-Sectional Study in Mysuru, India
by Nabeel Kinattingal, Seema Mehdi, Krishna Undela, Shahid Ud Din Wani, Mansour Almuqbil, Sultan Alshehri, Faiyaz Shakeel, Mohammad T. Imam and Santhepete N. Manjula
J. Pers. Med. 2023, 13(3), 524; https://doi.org/10.3390/jpm13030524 - 15 Mar 2023
Cited by 3 | Viewed by 1838
Abstract
The goal of this research is to study the prevalence of cognitive impairment in diabetes mellitus (DM) patients and establish the necessity of detecting and treating it early in these patients. A cross-sectional study was conducted at a tertiary care hospital in Mysuru [...] Read more.
The goal of this research is to study the prevalence of cognitive impairment in diabetes mellitus (DM) patients and establish the necessity of detecting and treating it early in these patients. A cross-sectional study was conducted at a tertiary care hospital in Mysuru for 4 months examined diabetic patients (test) and nondiabetic subjects (control) for cognitive decline using the Montreal Cognitive Assessment (MoCA) tool. Cognitive functions such as visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation were assessed in both groups. The diabetic group showed a significantly lower total MoCA score than the non-diabetic group (18.99 ± 0.48 and 26.21 ± 0.46, respectively; p < 0.001). Assessment of scores in diabetic patients demonstrated the significant influence of age demographics on cognitive impairment (p-value < 0.001). Furthermore, a higher proportion of diabetic patients displayed cognitive impairment despite a higher score in a single subdomain, making it evident that diabetes is diverse and multifactorial in origin, where oxidative stress and inflammatory responses play a predominant role. This study suggested that the local T2DM population residing in Mysuru (India) has a high prevalence of cognitive impairment, evident from poor performance in almost all cognitive domains assessed by MoCA. Future studies could examine the generalizability of cognitive function findings in diabetic patients across diverse geographic regions and ethnic groups, as well as investigate interventions such as lifestyle modifications and medication to prevent or delay cognitive decline in those with diabetes. Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
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Review

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14 pages, 437 KiB  
Review
Use of Ozone Therapy in Diabetic Foot Ulcers
by Álvaro Astasio-Picado, Alba Ángel Babiano, Miriam López-Sánchez, Rocio Ruiz Lozano, Paula Cobos-Moreno and Beatriz Gómez-Martín
J. Pers. Med. 2023, 13(10), 1439; https://doi.org/10.3390/jpm13101439 - 27 Sep 2023
Viewed by 1605
Abstract
Introduction: ozone therapy is a therapy composed of ozone. This gas is in the atmosphere with various general effects: direct disinfectant and trophic effects and a systemic antibacterial and antiviral effect. This gas also improves blood circulation, makes glucose metabolism more effective, improves [...] Read more.
Introduction: ozone therapy is a therapy composed of ozone. This gas is in the atmosphere with various general effects: direct disinfectant and trophic effects and a systemic antibacterial and antiviral effect. This gas also improves blood circulation, makes glucose metabolism more effective, improves erythrocyte metabolism, and improves fatty acid metabolism. Objective: Provide evidence of the effectiveness of ozone therapy in wounds of patients with diabetic foot. Analyze the effectiveness of ozone therapy compared to other treatments to achieve good wound healing in patients with diabetic foot. To study the benefits of the use of ozone therapy in ulcers of patients. Analyze the management of ozone therapy and other treatments to achieve healing of ulcers in patients. Methodology: A bibliographic review focused on articles published between November 2014 and June 2023 was carried out. The following databases were consulted: Pubmed (Medline), Dialnet, Google Scholar, Web of Science (WOS), Scielo, and Scopus. Results: After applying the article selection criteria and evaluating the quality of the methodology, a total of 17 articles were obtained. The results affirm ozone therapy as promising for the treatment of wounds in patients with diabetic foot. Conclusions: the evidence has been able to determine that ozone therapy is adequate for the treatment of diabetic foot ulcers. In addition, the therapy has been shown to be effective, safe, and beneficial, with few adverse effects for the treatment of diabetic foot ulcers. Full article
(This article belongs to the Special Issue Diabetes Mellitus: Current Research and Future Perspectives)
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