Personalized Prevention and Treatment in Endocrinology, Diabetes and Metabolic Diseases

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 1216

Special Issue Editor


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Guest Editor
MRC Epidemiology Unit, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
Interests: obesity; adipokines; myokines; personalized medicine; endocrinology

Special Issue Information

Dear Colleagues,

Recent technological advances, including the widespread application of multi-omics analyses, have paved the way for more personalized medical interventions based on individual characteristics. Indeed, in many aspects of modern medicine, including cancer treatment, clinical protocols have incorporated the use of genetic studies in order to inform decision making regarding different therapeutic options.

In diabetes and other potentially preventable metabolic diseases, the combined use of clinical data, genes, biomarkers, phenotypic characteristics, behaviors, etc., may stratify patients based on their risk of developing complications and/or the influence of decision models and algorithms on individualized treatment targets or therapies. Furthermore, with the increasing application of new real-time technologies, such as continuous glucose monitoring devices and the subsequent accumulation of day-by-day data, it is tempting to speculate that personalized preventive and/or therapeutic interventions may target individuals at both ends of the “average spectrum”, which might not fully benefit from current generic recommendations. However, this is currently more limited in daily endocrine clinical practice. Ultimately, it remains unclear whether the utilization of these novel biotechnological and molecular breakthroughs enhances or even outperforms classical methods of individualization based on more easily obtained clinical and/or biochemical parameters.

In this Special Issue of Life, I invite you to share your research on precision medicine in the field of diabetes and endocrinology, from prevention to therapies. I am hoping that this will create a forum in which ideas and suggestions regarding the maximization of these tools in our field will be presented and discussed. I warmly welcome both original research and review articles that highlight the achievements and challenges in the field, and that may further generate research ideas for future studies.

Dr. Grigorios Panagiotou
Guest Editor

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Keywords

  • personalized medicine
  • precision prevention
  • multi-omics
  • obesity
  • diabetes and endocrinology

Published Papers (2 papers)

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Research

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11 pages, 397 KiB  
Article
De-Intensification from Basal-Bolus Insulin Therapy to Liraglutide in Type 2 Diabetes: Predictive Value of Mean Glycaemia during Fasting Test
by Barbora Pavlikova, Martina Breburdova, Michal Krcma, Miroslav Kriz, Jan Kasparek and Zdenek Rusavy
Life 2024, 14(5), 568; https://doi.org/10.3390/life14050568 - 28 Apr 2024
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Abstract
Background: Successful conversion from insulin therapy to glucagon-like peptide 1 receptor agonist (GLP-1RA) with basal insulin in well-controlled patients has already been demonstrated. However, the data concerning individuals with poor glycaemic control are scarce. The aim of this work was to assess the [...] Read more.
Background: Successful conversion from insulin therapy to glucagon-like peptide 1 receptor agonist (GLP-1RA) with basal insulin in well-controlled patients has already been demonstrated. However, the data concerning individuals with poor glycaemic control are scarce. The aim of this work was to assess the success rate of insulin therapy to liraglutide transition in poorly controlled diabetes in a real-world clinical setting and to define predictors of success. We are the first to present the method of a fasting test as a way to identify the patients at higher risk of failure after treatment de-intensification. Methods: The retrospective observational study analyzed data of 62 poorly controlled obese diabetic patients on high-dose insulin therapy, who were subjected to a 72 h fasting test during hospitalization and subsequently switched to liraglutide ± basal insulin therapy. During the fasting, all antidiabetic treatment was discontinued. Patients were classified as responders if they remained on GLP-1RA treatment after 12 months. Non-responders restarted the basal-bolus insulin (BBI) regimen. Development of glycated hemoglobin (HbA1c) and body weight in both groups, alongside with parameters associated with the higher risk of return to the BBI regimen, were analyzed. Results: A total of 71% of patients were switched successfully (=responders). Responders had more significant improvement in HbA1c (−6.4 ± 19.7 vs. −3.4 ± 22.9 mmol/mol) and weight loss (−4.6 ± 7.1 vs. −2.5 ± 4.0). Statistically significant difference between groups was found in initial HbA1c (75.6 ± 17.9 vs. 90.5 ± 23.6; p = 0.04), total daily dose of insulin (67.6 ± 36.4 vs. 90.8 ± 32.4; p = 0.02), and mean glycaemia during the fasting test (6.9 ± 1.7 vs. 8.6 ± 2.2 mmol/L; p < 0.01). Conclusions: This study confirms that therapy de-intensification in poorly controlled patients with a BBI regimen is possible. Higher baseline HbA1c, total daily insulin dose, and mean glucose during fasting test are negative predictive factors of successful therapy de-escalation. Full article
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21 pages, 766 KiB  
Review
Physical Activity during Pregnancy and Risk of Gestational Diabetes Mellitus: A Meta-Review
by Carmen Rute-Larrieta, Gloria Mota-Cátedra, Juan Manuel Carmona-Torres, Victoria Mazoteras-Pardo, Esperanza Barroso-Corroto, Carlos Navarrete-Tejero, Michail Zografakis-Sfakianakis, Athina Patelarou, Maria Manuela Martins, Ana da Conceinçao Alves Faria and José Alberto Laredo-Aguilera
Life 2024, 14(6), 755; https://doi.org/10.3390/life14060755 - 13 Jun 2024
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Abstract
Background: Nowadays, pregnant women require more individualized attention in their assistance process during pregnancy. One of the aspects that requires the most focus is the suitability of carrying out physical activity. The objective of this meta-review is to find out the effects of [...] Read more.
Background: Nowadays, pregnant women require more individualized attention in their assistance process during pregnancy. One of the aspects that requires the most focus is the suitability of carrying out physical activity. The objective of this meta-review is to find out the effects of physical activity during pregnancy on the incidence of GDM compared to women who do not perform physical activity. Methods: A search was conducted in Cochrane, CSIC, Ebscohost, Proquest, Pubmed, Scielo, and Scopus. The search focused on systematic reviews and meta-analyses published in the last five years. The AMSTAR-2 scale was used as a quality assessment tool for the final sample. Results: A total of 18 systematic reviews and meta-analyses were included. Sixteen of them found out that physical activity during pregnancy has preventive effects for GDM compared with women who lacked physical activity. Among the studies, we found a reduction in the risk of GDM of between 24% and 38% and odds ratios ranging between 0.39 and 0.83 calculated for a 95% CI. Only two studies did not find statistically significant effects. Other variables such as type and duration of physical activity, overweight and obesity, gestational age, etc., were also considered. Conclusions: Physical activity prevents the incidence of GDM. The main characteristics that enhance this preventive effect are starting at the initial stages of pregnancy and maintaining during the whole pregnancy as well as combining strength and aerobic exercise at a low to moderate intensity. Full article
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