Modern Management and Treatment of Diabetes—Celebrating the 100th Anniversary of the First Diabetic Patient Who Received Insulin

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Endocrinology".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 25850

Special Issue Editors


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Guest Editor
Department of Internal Medicine and Medical Specialties (DIMIS), Università degli Studi di Palermo UNIPA, 90100 Palermo, Italy
Interests: cardiovascular risk; lipids; diabetes; prevention; therapy; metabolic syndrome; metabolism; lipoproteins; incretins; nutraceuticals
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Maternity District Hospital Elena Venizelou, 115 21 Athens, Greece
Interests: thyroid; bone metabolism; osteoporosis; adrenals; diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Diabetes mellitus (DM) is a scourge of our time, with an ever-increasing trend in all countries. The International Diabetes Federation (IDF) estimates that the total number of people with type 2 DM (DM2) is 425 million worldwide, with the ominous prospect of reaching 693 million in 2045. The upward trend of the disease is due in large part to the modern way of life, with aggravating factors being obesity, lack of exercise and chronic stress. Type 1 DM (DM1) shows an equally increasing trend (over 3%) every year. An extremely worrying phenomenon is the increasing incidence of obesity and DM2 in children and adolescents.

However, the improvement of therapeutic approaches and the prevention of DM in recent years is promising, having catalyzed the mitigation of risk and the management of acute and chronic complications. As a matter of fact, looking at the risk and causes of death in the United States over the past 20 years, despite the increase in DM2 (which tripled), there was no corresponding increase in deaths, mainly due to a reduction in cardiovascular complications (mainly heart attacks/strokes).

DM is a complex systemic disease and affects not only glucose metabolism, but the whole of cellular metabolism in all tissues without exception. In the course of the disease, comorbidities emerge from all systems (cardiovascular, nervous, digestive, kidney, skin, even from the mental sphere), as a result of chronic hyperglycemia–dyslipidemia and chronic complications. For this reason optimal metabolic regulation is considered imperative. The introduction of pioneering drugs, the combinations of which offer flexibility and effectiveness in treatment options, has made a decisive contribution in achieving this goal. At the same time, the rapid development of technology, and its application in the field of DM (new generation insulin pumps, artificial pancreas, modern devices for measuring blood glucose, devices for continuous glucose monitoring), has augmented the capability of "tightening" glycemic regulation.

The aim of the present Special Issue is to harmoniously combine the latest scientific data with clinical practice, in an effort to cover the full range of pathophysiology, prevention, treatment and monitoring of DM and its complications. This issue has coincided with an anniversary milestone in DM: the 100th anniversary of the discovery of insulin, the hormone that has given life to millions of people around the world.

With this vision, we invite you to contribute to this Special Issue of Medicina

Dr. Manfredi Rizzo
Dr. Ioannis Ilias
Guest Editors

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Keywords

  • diabetes complications
  • diabetes
  • gestational diabetes mellitus
  • hyperglycemia
  • insulin
  • nephropathy
  • neuropathy
  • pancreas
  • retinopathy

Published Papers (6 papers)

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Research

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12 pages, 1168 KiB  
Article
Clinical Study of Serum Serotonin as a Screening Marker for Anxiety and Depression in Patients with Type 2 Diabetes
by Lavinia-Alexandra Moroianu, Curis Cecilia, Valeriu Ardeleanu, Anca Pantea Stoian, Vasilica Cristescu, Raisa-Eloise Barbu and Marius Moroianu
Medicina 2022, 58(5), 652; https://doi.org/10.3390/medicina58050652 - 11 May 2022
Cited by 9 | Viewed by 2808
Abstract
Over time, studies have shown the importance of determining serotonin levels to diagnose somatic and psychiatric disorders. There are theoretical premises and practical ways to achieve a subtle correlation between the existence of comorbid psychiatric disorders and somatic diseases caused by the changes [...] Read more.
Over time, studies have shown the importance of determining serotonin levels to diagnose somatic and psychiatric disorders. There are theoretical premises and practical ways to achieve a subtle correlation between the existence of comorbid psychiatric disorders and somatic diseases caused by the changes observed in serotonin levels. The present study, classified as retrospective and quantitative, provides evidence for determining the serotonin levels in patients with diabetes and anxiety or depression. A total of 48 patients with diabetes type 2 were enrolled in the study. Blood glucose level, glycated haemoglobin, and serum serotonin were noted, and they completed Hamilton A and Beck Depression Inventory questionnaires. We found robust correlations between serum serotonin and blood glucose (Sig. = 0.008), serum serotonin and HbA1c (Sig. = 0.007), serum serotonin and anxiety (Sig. = 0.000), and serum serotonin and depression (Sig. = 0.000). It is also noteworthy that women recorded extreme values higher than men for glycated haemoglobin (95% confidence interval: 6.92–7.79 in women and 6.30–7.23 in men). In conclusion, using serotonin as a marker of the mentioned diseases in clinical practice is of significant utility, considering the benefits in terms of the evolution and prognosis of comorbidities in patients with type 2 diabetes and anxiety and depressive symptoms. Full article
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Review

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7 pages, 608 KiB  
Review
Does Iodine Influence the Metabolism of Glucose?
by Ioannis Ilias, Charalampos Milionis, Lina Zabuliene and Manfredi Rizzo
Medicina 2023, 59(2), 189; https://doi.org/10.3390/medicina59020189 - 17 Jan 2023
Cited by 1 | Viewed by 4775
Abstract
Thyroid function and glucose status are linked; experimental, clinical, and epidemiological studies have shown this. Iodine is a vital trace element that is inextricably linked to thyroid hormone synthesis. The latter is also associated with glucose metabolism and diabetes. Recently, some—but not all—studies [...] Read more.
Thyroid function and glucose status are linked; experimental, clinical, and epidemiological studies have shown this. Iodine is a vital trace element that is inextricably linked to thyroid hormone synthesis. The latter is also associated with glucose metabolism and diabetes. Recently, some—but not all—studies have shown that iodine is linked to glucose metabolism, glucose intolerance, impaired fasting glucose, prediabetes, diabetes mellitus, or gestational diabetes. In this concise review, we review these studies, focusing on iodine and glucose metabolism and prediabetic conditions or type 2 diabetes mellitus. The potential beneficial effect of iodine on glucose metabolism may be attributed to its antioxidant properties. Full article
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11 pages, 1096 KiB  
Review
Insulin Pump Therapy Efficacy and Key Factors Influencing Adherence in Pediatric Population—A Narrative Review
by Laura Mihaela Trandafir, Stefana Maria Moisa, Mihaela Victoria Vlaiculescu, Lacramioara Ionela Butnariu, Laura Otilia Boca, Maria Magdalena Leon Constantin, Paula Madalina Lupu, Crischentian Brinza, Oana Raluca Temneanu and Alexandru Burlacu
Medicina 2022, 58(11), 1671; https://doi.org/10.3390/medicina58111671 - 18 Nov 2022
Cited by 2 | Viewed by 2710
Abstract
Objective: we aimed to highlight the state of the art in terms of pediatric population adherence to insulin pumps. This study intends to underline the significance of identifying and minimizing, to the greatest extent feasible, the factors that adversely affect the juvenile [...] Read more.
Objective: we aimed to highlight the state of the art in terms of pediatric population adherence to insulin pumps. This study intends to underline the significance of identifying and minimizing, to the greatest extent feasible, the factors that adversely affect the juvenile population’s adherence to insulin pump therapy. Materials and methods: articles from PubMed, Embase, and Science Direct databases were evaluated using the following search terms: adherence, pump insulin therapy, children, pediatric population, and type 1 diabetes, in combination with several synonyms such as compliance, treatment adherence, pump adherence, patient dropouts, and treatment refusal. Results: A better glycemic control is connected to a better adherence to diabetes management. We identify, enumerate, and discuss a number of variables which make it difficult to follow an insulin pump therapy regimen. Several key factors might improve adherence to insulin pump therapy: efficient communication between care provider and patients (including home-based video-visits), continuous diabetes education, family support and parental involvement, as well as informational, practical assistance, and emotional support from the society. Conclusions: every cause and obstacle that prevents young patients from adhering to insulin pumps optimally is an opportunity for intervention to improve glycemic control and, as a result, their quality of life. Full article
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17 pages, 647 KiB  
Review
An Update on the Current and Emerging Use of Thiazolidinediones for Type 2 Diabetes
by Rosaria Vincenza Giglio, Nikolaos Papanas, Ali Abbas Rizvi, Marcello Ciaccio, Angelo Maria Patti, Ioannis Ilias, Anca Pantea Stoian, Amirhossein Sahebkar, Andrej Janez and Manfredi Rizzo
Medicina 2022, 58(10), 1475; https://doi.org/10.3390/medicina58101475 - 17 Oct 2022
Cited by 14 | Viewed by 2841
Abstract
Guidelines have increasingly stressed the concept that adequate glycemic control is required to prevent or decrease the macro- and microvascular complications of type 2 diabetes mellitus (T2DM). PPAR-gamma agonists (“glitazones”) are no longer prioritized due to their effects on heart failure. However, the [...] Read more.
Guidelines have increasingly stressed the concept that adequate glycemic control is required to prevent or decrease the macro- and microvascular complications of type 2 diabetes mellitus (T2DM). PPAR-gamma agonists (“glitazones”) are no longer prioritized due to their effects on heart failure. However, the association between these drugs and innovative therapies could be a valuable tool to attenuate the risk factors of the metabolic syndrome. Glitazones are used for the treatment of diabetes and associated comorbidities. There is substantial scientific evidence demonstrating the effect of glitazones at a cardiometabolic level, as well as on hematological and neurological pathologies that point to their usefulness. The use of glitazones has always been controversial both for the type of patients who must take these drugs and for the side effects associated with them. Unfortunately, the recent guidelines do not include them among the preferred drugs for the treatment of hyperglycemia and rosiglitazone is out of the market in many countries due to an adverse cardiovascular risk profile. Even though real-life studies have proven otherwise, and their pleiotropic effects have been highlighted, they have been unable to achieve primacy in the choice of antihyperglycemic drugs. It would be appropriate to demonstrate the usefulness of pioglitazone and its therapeutic benefit with further cardiovascular safety studies. Full article
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28 pages, 2125 KiB  
Review
Diabetes-Modifying Antirheumatic Drugs: The Roles of DMARDs as Glucose-Lowering Agents
by Marco Infante, Nathalia Padilla, Rodolfo Alejandro, Massimiliano Caprio, David Della-Morte, Andrea Fabbri and Camillo Ricordi
Medicina 2022, 58(5), 571; https://doi.org/10.3390/medicina58050571 - 21 Apr 2022
Cited by 5 | Viewed by 6119
Abstract
Systemic inflammation represents a shared pathophysiological mechanism which underlies the frequent clinical associations among chronic inflammatory rheumatic diseases (CIRDs), insulin resistance, type 2 diabetes (T2D), and chronic diabetes complications, including cardiovascular disease. Therefore, targeted anti-inflammatory therapies are attractive and highly desirable interventions to [...] Read more.
Systemic inflammation represents a shared pathophysiological mechanism which underlies the frequent clinical associations among chronic inflammatory rheumatic diseases (CIRDs), insulin resistance, type 2 diabetes (T2D), and chronic diabetes complications, including cardiovascular disease. Therefore, targeted anti-inflammatory therapies are attractive and highly desirable interventions to concomitantly reduce rheumatic disease activity and to improve glucose control in patients with CIRDs and comorbid T2D. Therapeutic approaches targeting inflammation may also play a role in the prevention of prediabetes and diabetes in patients with CIRDs, particularly in those with traditional risk factors and/or on high-dose corticosteroid therapy. Recently, several studies have shown that different disease-modifying antirheumatic drugs (DMARDs) used for the treatment of CIRDs exert antihyperglycemic properties by virtue of their anti-inflammatory, insulin-sensitizing, and/or insulinotropic effects. In this view, DMARDs are promising drug candidates that may potentially reduce rheumatic disease activity, ameliorate glucose control, and at the same time, prevent the development of diabetes-associated cardiovascular complications and metabolic dysfunctions. In light of their substantial antidiabetic actions, some DMARDs (such as hydroxychloroquine and anakinra) could be alternatively termed “diabetes-modifying antirheumatic drugs”, since they may be repurposed for co-treatment of rheumatic diseases and comorbid T2D. However, there is a need for future randomized controlled trials to confirm the beneficial metabolic and cardiovascular effects as well as the safety profile of distinct DMARDs in the long term. This narrative review aims to discuss the current knowledge about the mechanisms behind the antihyperglycemic properties exerted by a variety of DMARDs (including synthetic and biologic DMARDs) and the potential use of these agents as antidiabetic medications in clinical settings. Full article
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14 pages, 761 KiB  
Review
Metformin: Sex/Gender Differences in Its Uses and Effects—Narrative Review
by Ioannis Ilias, Manfredi Rizzo and Lina Zabuliene
Medicina 2022, 58(3), 430; https://doi.org/10.3390/medicina58030430 - 16 Mar 2022
Cited by 16 | Viewed by 5591
Abstract
Metformin (MTF) occupies a major and fundamental position in the therapeutic management of type 2 diabetes mellitus (T2DM). Gender differences in some effects and actions of MTF have been reported. Women are usually prescribed lower MTF doses compared to men and report more [...] Read more.
Metformin (MTF) occupies a major and fundamental position in the therapeutic management of type 2 diabetes mellitus (T2DM). Gender differences in some effects and actions of MTF have been reported. Women are usually prescribed lower MTF doses compared to men and report more gastrointestinal side effects. The incidence of cardiovascular events in women on MTF has been found to be lower to that of men on MTF. Despite some promising results with MTF regarding pregnancy rates in women with PCOS, the management of gestational diabetes, cancer prevention or adjunctive cancer treatment and COVID-19, most robust meta-analyses have yet to confirm such beneficial effects. Full article
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