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Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and...
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Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 2384

Special Issue Editors

Prof. Dr. Ionela Lacramioara Serban

E-Mail Website
Guest Editor
Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: endothelial dysfunction; oxidative stress; atherosclerosis; molecular biology; inflammatory diseases; cardiovascular diseases; type 2 diabetes
Special Issues, Collections and Topics in MDPI journals
Dr. Daniela Maria Tanase

E-Mail Website
Guest Editor
Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: cardiovascular diseases; cardiovascular complications; atherosclerosis; oxidative stress; inflammatory bowel disease; nonalcoholic fatty liver disease; gut microbiota; dysbiosis; type 2 diabetes
Special Issues, Collections and Topics in MDPI journals
Dr. Mariana Floria

E-Mail Website
Guest Editor
Department of Internal Medicine,“Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: arrhythmias; atrial fibrillation; left atrium; cardiovascular disease; cardiovascular risk factor; echocardiography; gastroesophageal reflux disease; metabolic disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetes mellitus, a complex syndrome characterized by abnormalities in every aspect of cellular energy metabolism, and its complications are among the most important health problems in the world. The major pathophysiological mechanisms underlying the pathogenesis of diabetes mellitus and its complications involve insulin resistance, immunological defect, an impaired incretin effect, gluco- and lipotoxicity, inflammation, oxidative stress, endoplasmic reticulum stress, defective autophagy mechanisms, proapoptotic pathways, modification of the intestinal microbiome, and abnormal mitochondrial function in insulin-sensitive tissues such as the liver, skeletal muscle, adipose tissue, blood vessels, nervous system, and myocardium.

In recent years, evidence-based treatment algorithms have been proposed for patients with diabetes, focusing on patients comorbidities as a critical determinant of the selection of the most appropriate treatment. Nowadays, it is widely recognized that diabetes mellitus is associated not only with cardiovascular mortality but also with poor quality of life due to, for example, chronic kidney disease, sarcopenia, cancer and dementia. To overcome these problems, it is important to better understand the disease process of diabetes and its complications and develop new treatment strategies. Acute complications include hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar state, and hyperglycemic diabetic coma. Chronic vascular (chronic microvascular complications: nephropathy, neuropathy and retinopathy; chronic macrovascular complications: coronary artery disease, peripheral arterial disease and cerebrovascular disease) and non-vascular complications are also involved.

The purpose of this Special Issue is to provide a platform to disseminate knowledge about diabetes. We invite submissions of both original research and comprehensive review articles. Potential topics include, but are not limited to, the following:

  • Work on the molecular mechanisms of diabetes-related diseases;
  • Potential new biomarkers for the prediction of diabetes and its complications;
  • Physiopathological concepts related to the mechanisms described above;
  • Innovative diagnostic tools and technologies for early detection, risk assessment and monitoring;
  • Diabetes and metabolic syndrome;
  • Diseases associated with diabetes (vascular and non-vascular complications);
  • Advancements in pharmacological and non-pharmacological approaches to improve treatment outcomes and treatment strategies (medical nutrition, metabolic surgery, drugs, and innovative approaches based on nanotechnology or artificial intelligence) in the context of precision diabetology.

Prof. Dr. Ionela Lacramioara Serban
Dr. Daniela Maria Tanase
Dr. Mariana Floria
Guest Editors

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. Life is an international peer-reviewed open access monthly 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

  • cardiovascular disease
  • hyperlipidemia
  • neuropathy
  • nephropathy
  • retinopathy
  • skin conditions
  • impaired wound healing
  • hearing impairment
  • psychological effects
  • epigenetic imprinting
  • molecular profiling
  • biomarkers
  • targeted therapy
  • glucose control
  • conventional and complementary approaches
  • stem cell damage
  • vascular damage and regeneration
  • diabetes complications

Published Papers (3 papers)

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Research

13 pages, 530 KiB  
Article
Utility of Fasting C-Peptide for the Diagnostic Differentiation of Patients with Type 1, Type 2 Diabetes, MODY, and LADA
by Ricardo Alemán-Contreras, Rita A. Gómez-Díaz, Maura E. Noyola-García, Rafael Mondragón-González, Niels Wacher and Aldo Ferreira-Hermosillo
Life 2024, 14(5), 550; https://doi.org/10.3390/life14050550 - 25 Apr 2024
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Abstract
Background: The prevalence of obesity has increased in patients with type 1 diabetes (T1D) and latent autoimmune diabetes of the adult (LADA), limiting the use of clinical features such as the body mass index for its differentiation with type 2 diabetes (T2D). Additionally, [...] Read more.
Background: The prevalence of obesity has increased in patients with type 1 diabetes (T1D) and latent autoimmune diabetes of the adult (LADA), limiting the use of clinical features such as the body mass index for its differentiation with type 2 diabetes (T2D). Additionally, some patients with maturity-onset diabetes of the young (MODY) or LADA are misdiagnosed as having T2D. The evaluation of autoantibodies and genetic testing are not fully available. We aimed to evaluate the utility of a widely available and less expensive diagnostic tool such as C-peptide to differentiate between T1D, T2D, MODY, and LADA. Methods: Our study included 38 patients with T1D, 49 with T2D, 13 with MODY, and 61 with LADA. We recorded anthropometric measurements, biochemical profiles, and antidiabetic treatment and determined C-peptide, anti-GAD65, and anti-IA2 antibodies. Results: C-peptide concentration differed significantly among populations (T1D: 0.2 ng/mL; T2D: 2.4 ng/mL; MODY: 1.14 ng/mL; LADA: 1.87 ng/mL). Through a ROC curve, we observed that the C-peptide cut-off point of 0.95 ng/mL allows differentiation between T1D and T2D (sensitivity 82%, specificity 77%); 0.82 ng/mL between T1D and LADA (sensitivity 82%, specificity 77%); and 1.65 ng/mL between T2D and MODY (sensitivity 72%, specificity 72%). Conclusions: C-peptide is useful for the diagnostic differentiation of patients with type 1, type 2 diabetes, MODY, and LADA. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges)
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14 pages, 1953 KiB  
Article
The Impact of Diabetes Education on Continuous Glucose Monitoring in SUS-Dependent Patients in a Northeastern Brazilian City
by Lysandro Pinto Borges, Pamela Chaves de Jesus, Jessiane Bispo de Souza, Deise Maria Rego Rodrigues Silva, Pedro Henrique Macedo Moura, Ronaldy Santana Santos, Marina dos Santos Barreto, Adriana Gibara Guimarães, Lucas Alves da Mota Santana, Dennyson Leandro Mathias da Fonseca, Ikaro Daniel de Carvalho Barreto, Breno de Mello Silva, Carla Raquel Pereira Oliveira, Karla Freire Rezende, Naira Horta Melo, Elenalda Ferreira dos Santos, Carmem Lúcia Matias de Queiroz, Lucia Helena Modesto Xavier, Otávio Cabral-Marques and Eloia Emanuelly Dias Silva
Life 2024, 14(3), 320; https://doi.org/10.3390/life14030320 - 28 Feb 2024
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Abstract
Background: Diabetes Mellitus (DM) is an important chronic disease that occurs worldwide. Aims: This study aims to investigate how the use of the FreeStyle® Libre system in Unified Health System (SUS) patients impacts diabetes parameters in patients who receive education on proper [...] Read more.
Background: Diabetes Mellitus (DM) is an important chronic disease that occurs worldwide. Aims: This study aims to investigate how the use of the FreeStyle® Libre system in Unified Health System (SUS) patients impacts diabetes parameters in patients who receive education on proper insulin administration and the use of the continuous monitoring device, as well as how this affects patients without any concomitant multidisciplinary support in Sergipe, Brazil. Methods: We conducted a prospective randomized study in a diabetes clinic in Sergipe, Brazil, using the flash method FreeStyle® Libre (Abbott). The participants were divided into two groups: one receiving diabetes education on CGM (continuous glucose monitoring), while the other did not. Before the intervention, the patient’s treatment motivation and quality of life were assessed using a questionnaire, and baseline levels of glycated hemoglobin were measured using high-performance liquid chromatography (HPLC) and the point of care AlereTM Afinion with boronate fixation. We compared first- and second-phase data with respect to glycated hemoglobin, mean interstitial blood glucose, time on and above target for hypoglycemic and hyperglycemic events, and mean hypoglycemic duration. Results: In group A, which received the diabetes education intervention, there was a significant reduction in average HbA1c levels from 8.6% to 7.9% after 3 months (p = 0.001). However, there was no significant difference in average glycemic values. Time above target decreased significantly from 50.62% to 29.43% (p = 0.0001), while time below target decreased from 22.90% to 20.21% (p = 0.002). There was no significant change in the number of hypoglycemic events, but the duration of hypoglycemia decreased significantly from 130.35 min to 121.18 min after 3 months (p = 0.0001). In Group B, there was no significant difference in mean HbA1c levels before (7.07%) and after (7.28%) sensor installation. This group maintained lower HbA1c levels compared to the other group. Average blood glucose levels also remained similar before (148.37 mg/dL) and after (154.65 mg/dL) the intervention. Although the time above the target glucose level increased significantly from 35.94% to 48.17%, the time at target decreased from 50.40% to 37.97%. No significant changes were observed in the time below target, the number of hypoglycemic events, or the duration of hypoglycemia. Conclusions: Our findings indicate that utilizing continuous glucose monitoring technology can enhance glycemic control, particularly in motivated, educated, low-income patients dependent on the SUS. To achieve positive results with FreeStyle Libre, it is imperative to allocate resources for multidisciplinary support. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges)
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13 pages, 646 KiB  
Article
Novel Activity of Oral Hypoglycemic Agents Linked with Decreased Formation of Tryptophan Metabolite, Kynurenic Acid
by Kinga Bednarz, Kamila Kozieł and Ewa M. Urbańska
Life 2024, 14(1), 127; https://doi.org/10.3390/life14010127 - 15 Jan 2024
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Abstract
Kynurenic acid is a tryptophan (Trp) metabolite formed along the kynurenine (KYN) pathway in the brain and in peripheral tissues. The disturbed formation of kynurenic acid, which targets glutamate-mediated neurotransmission, GPR35, and aryl hydrocarbon receptors of immune or redox status, was implicated in [...] Read more.
Kynurenic acid is a tryptophan (Trp) metabolite formed along the kynurenine (KYN) pathway in the brain and in peripheral tissues. The disturbed formation of kynurenic acid, which targets glutamate-mediated neurotransmission, GPR35, and aryl hydrocarbon receptors of immune or redox status, was implicated in the development of neuropsychiatric and metabolic disorders among others. Kynurenic acid exerts neuroprotective and immunomodulatory effects, yet its high brain levels may negatively impact cognition. Changes in the Trp–KYN pathway are also linked with the pathogenesis of diabetes mellitus, which is an established risk factor for cardiovascular and neurological diseases or cognitive deficits. Here, the effects of metformin and glibenclamide on the brain synthesis of kynurenic acid were evaluated. Acute exposure of rat cortical slices in vitro to either of the drugs reduced kynurenic acid production de novo. Glibenclamide, but not metformin, inhibited the activity of kynurenic acid biosynthetic enzymes, kynurenine aminotransferases (KATs) I and II, in semi-purified cortical homogenates. The reduced availability of kynurenic acid may be regarded as an unwanted effect, possibly alleviating the neuroprotective action of oral hypoglycemic agents. On the other hand, considering that both compounds ameliorate the cognitive deficits in animal and human studies and that high brain kynurenic acid may hamper learning and memory, its diminished synthesis may improve cognition. Full article
(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges)
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