To investigate the role of early pregnancy thyroid function in gestational diabetes mellitus (GDM) development and its influencing factors.

This large-scale retrospective cohort study assessed the associations between early pregnancy thyroid hormones and GDM subtypes, as well as their non-linear relationship with oral glucose tolerance test (OGTT) glucose levels, using multivariate logistic regression and restricted cubic spline models. Subgroup analyses were conducted within the normal thyroid function range to evaluate the risk associated with low-normal FT4 levels.

A total of 40,682 pregnant women were included and classified into four groups based on glucose levels: isolated fasting hyperglycemia (IFH), isolated post-load hyperglycemia (IPH), combined hyperglycemia (CH), and normal glucose tolerance (NGT). Free thyroxine (FT4) showed strong capability in differentiating among the subtypes, while thyroid-stimulating hormone (TSH) had limited effects. Multivariate and non-linear analyses showed a J-shaped association between FT4 and fasting/1-hour OGTT glucose, with strong protection below 15.4 pmol/L. In contrast, TSH showed weaker associations without a clear threshold effect. Importantly, low-normal FT4 (11.6-15.4 pmol/L), even within the normal range, independently increased GDM risk, especially in nulliparous and overweight/obese women.

FT4 is an independent risk factor for GDM, with parity and pre-pregnancy BMI serving as important effect modifiers. Even the low-normal FT4 levels are associated with a higher risk of developing GDM and macrosomia.

Diabetic kidney disease (DKD) is a highly significant microvascular complication that arises from diabetes. Therefore, this study aimed to ascertain the traditional risk factors for DKD in type 2 diabetes mellitus (T2DM) in Asia, raising awareness of these risk factors among patients with T2DM.

PubMed, Embase, Web of Science, and Cochrane Library were systematically searched until 13 Mar 2026. Case-control or cohort studies in Asia on the risk factors for DKD were included. Egger's test and funnel plots were used to assess publication bias. Stata 15 was used for statistical analysis.

7 case-control studies (including 3,312 participants) and 17 cohort studies (including 8,735 participants) were included. All the included studies were of high quality according to the Newcastle-Ottawa Scale (NOS). Systolic blood pressure (SBP), hypertension, glycosylated hemoglobin (HbA1c), waist-to-hip ratio (WHR), fasting blood glucose (FBG), uric acid (UA), creatinine (Cr), age and diabetes duration were risk factors for DKD in T2DM. Diabetic retinopathy (DR) was closely associated with DKD, and this association was also evident in subgroups defined by pathological diagnosis. SBP was a risk factor in both the clinical diagnosis group and the pathological diagnosis group.

This meta-analysis preliminarily demonstrates that SBP, hypertension, HbA1c, WHR, FBG, UA, Cr, age, diabetes duration and DR are associated with DKD in Asia. SBP and DR are associated with renal biopsy-confirmed DKD.

https://www.crd.york.ac.uk/PROSPERO/recorddashboard, identifier CRD42024529789.

Achieving rapid glycemic stabilization is a critical goal in the inpatient management of type 2 diabetes mellitus(T2DM). This study aimed to develop and validate a nomogram incorporating the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and key clinical parameters to predict the time to glycemic stability in hospitalized T2DM patients.

We conducted a retrospective analysis of 356 hospitalized T2DM patients. Baseline demographic, clinical, and laboratory data, including the HALP score, were collected. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent predictors for the time to glycemic stability. The model's discriminative ability was assessed using the concordance index, and its calibration was evaluated with calibration curves. Decision curve analysis (DCA) was used to estimate clinical utility.

Multivariate Cox regression analysis identified older age, lower hemoglobin level, higher hemoglobin A1c (HbA1c), and a lower HALP score as independent risk factors associated with a longer time to glycemic stability. These four variables were integrated into a prognostic nomogram, which demonstrated good predictive accuracy, with a C-index of 0.81(95% CI:0.78 - 0.84) in the training cohort. The calibration curves showed satisfactory agreement between predicted and observed probabilities. Decision curve analysis (DCA) indicated favorable clinical net benefit across a reasonable range of threshold probabilities.

We developed and validated a practical nomogram that effectively predicts the time to glycemic stability in hospitalized T2DM patients, that may assist clinicians in early identification of patients at risk for delayed stabilization, thereby facilitating personalized management strategies and optimizing inpatient diabetes care.

This study aimed to evaluate the clinical utility of novel inflammatory and metabolic composite indices in early risk prediction of microvascular complications in patients with type 2 diabetes mellitus (T2DM), and to provide reliable evidence for early precision risk stratification.

A retrospective analysis was conducted on 964 hospitalized patients with T2DM admitted to the Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, from September 2023 to March 2025. Patients were randomly assigned to a training cohort and a validation cohort at a ratio of 7:3 using a random number table. In the training cohort, least absolute shrinkage and selection operator (LASSO) regression was applied for variable selection and to reduce multicollinearity, followed by univariate and multivariate logistic regression analyses to identify independent risk factors for T2DM related microvascular complications. Receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were employed to comprehensively assess the predictive performance and clinical utility of the model.

Multifactorial logistic regression analysis showed that age, duration of diabetes, duration of hypertension, urine albumin-to-creatinine ratio (UACR) > 30 mg/g, as well as core indicators SIRI and TyG index, were significantly associated with the occurrence of microvascular complications in type 2 diabetes mellitus (T2DM) (P < 0.05). The predictive model constructed based on LASSO-logistic regression demonstrated an AUC of 0.869 (95% CI: 0.842-0.895) in the training set and an AUC of 0.864 (95% CI: 0.824-0.905) in the validation set, indicating stable and excellent discriminatory ability.

This study confirms that SIRI and TyG index can serve as independent risk factors for microvascular complications in T2DM. The nomogram model constructed based on LASSO-logistic regression shows significantly better predictive performance than single indicators, with good model calibration, demonstrating excellent clinical net benefit. This model can accurately assess the risk of microvascular complications, providing reliable decision support for early clinical screening and risk stratification management.

Recent studies suggest that the development of prediabetes and its associated comorbidities may depend on sex and reproductive status. While the exact mechanism is unclear, differences in insulin sensitivity, body fat distribution, and glucose and lipid metabolism may play a role. In this study, we investigated how sex differences in metabolic and inflammatory parameters affect the development of prediabetic conditions in a non-obese rat model with severe dyslipidaemia.

Wistar Kyoto (WKY) rats served as the control group, while age-matched Hereditary Hypertriglyceridaemic (HHTg) rats were used as a non-obese, prediabetic model with genetically determined hypertriglyceridaemia, insulin resistance and impaired glucose tolerance.

Compared to WKY controls, the HHTg strain exhibited increased serum triacylglyceroles (TAG) as well as ectopic TAG accumulation in the liver, heart and skeletal muscle which was more pronounced in HHTg females. However, this higher ectopic TAG accumulation in HHTg females was not associated with increased lipotoxic diacylglyceroles. The HHTg strain showed increased visceral adiposity, which was distributed differently: HHTg females had increased perimetrial adipose tissue, while HHTg males had increased perirenal adipose tissue. Impaired insulin sensitivity was observed in both sexes of the HHTg strain in skeletal muscle and adipose tissue. Insulin resistance in the HHTg strain may be due to elevated leptin and NEFA levels, as well as decreased GLUT4 in skeletal muscle. In addition, the HHTg strain showed impaired glucose tolerance, as well as hyperinsulinaemia, which was more pronounced in HHTg males. Increased lipogenesis (mRNA Scd1), oxidative stress (decreased SOD activity) and inflammation (mRNA Tnfα) in the liver may contribute to the development of hepatic steatosis and hepatic lipid accumulation. In visceral adipose tissue, increased mRNA Hif1 may contribute to adipose tissue hypoxia and impair insulin sensitivity, particularly in males.

Despite having more pronounced dyslipidaemia, ectopic lipid accumulation, and visceral adiposity, prediabetic females have better glucose tolerance and insulin sensitivity markers than prediabetic males. These sex differences may be due to variations in fat distribution, lipid metabolism and chronic inflammation. Our findings suggest that males are more susceptible to developing early prediabetic damage, such as insulin resistance and fatty liver, regardless of obesity.

Pre-procedural anxiety in patients with intravitreal injections shows a significant negative association with vision-related quality of life. This study determines the effect of telenursing with self-care education podcasts on anxiety and quality of life in patients with diabetes undergoing intravitreal injections.

A randomized clinical trial was conducted in 2022 in Mashhad, Iran on 68 patients assigned to two groups. After informed consent were obtained, patients completed a demographic questionnaire, the Spielberger State-Trait Anxiety Inventory, and the SF-36 quality of life questionnaire. Relevant podcasts were delivered individually via WhatsApp once a week over an 8-week period to the intervention group (n=34), while the control group (n=34) received routine education via pamphlets. Anxiety levels were measured before the commencement of the intervention and each injection; the quality-of-life questionnaire was administered before and after the completion of the intervention. Data were analyzed using SPSS version 26. The statistical tests included the t-test, Chi square, repeated measures ANOVA, ANCOVA, and Mann-Whitney U test.

The intervention group demonstrated a significantly greater reduction in both state anxiety (P<0.001) and trait anxiety (P<0.001) over the eight-week study period compared to the control group. Furthermore, the intervention group comparison with the control group showed statistically significant improvement in the total score of quality-of-life (P<0.001).

A telenursing program delivered via self-care podcasts, a feasible task for community nurses, significantly reduced anxiety and improved quality of life in patients with diabetic retinopathy undergoing intravitreal injections.Trial Registration Number: IRCT20220611055134N.

Percutaneous coronary intervention (PCI) is extensively employed for the therapy of coronary artery disease; nonetheless, patient demographics and cardiovascular risk factors continue to impact procedural and clinical results Objective: To evaluate the association between patient demographics and cardiovascular risk factors and in-hospital clinical outcomes, including major adverse cardiovascular events (MACE), stent thrombosis, and mortality, among patients undergoing PCI.

This hospital-based observational study was conducted over a one-year period from July 2023 to June 2024. A total of 270 adult patients undergoing elective or emergency PCI were enrolled using a convenience sampling technique. Data on demographic characteristics, cardiovascular risk factors, procedural details, and in-hospital outcomes were collected using a structured proforma designed by hospital staff and research investigators. Statistical analysis was performed using SPSS version 26 (IBM Corp., Armonk, New York, USA), including chi-square tests, independent-samples t-tests, and multivariate logistic regression to identify independent predictors of adverse outcomes.

Of the 270 patients, 185 (68.52%) were male and 93 (34.44%) were aged ≥60 years. Hypertension was present in 158 (58.52%) patients, and diabetes mellitus in 120 (44.44%) patients. Procedural success was achieved in 250 (92.59%) cases, while in-hospital major adverse cardiovascular events (MACE) occurred in 20 (7.41%), stent thrombosis in 8 (2.96%), and mortality in 5 (1.85%) patients. Patients who developed MACE were significantly older than those with procedural success (61.7 ± 9.5 vs. 55.3 ± 10.2 years; p = 0.034). Multivariate analysis identified age ≥60 years (adjusted OR: 2.10; p = 0.035) and diabetes mellitus (adjusted OR: 3.25; p = 0.003) as independent predictors of adverse PCI outcomes.

Advanced age and diabetes mellitus were significant determinants of adverse in-hospital outcomes following PCI despite high overall procedural success rates.

Type 1 diabetes (T1D) is driven by autoimmune destruction of pancreatic β-cells and remains incurable despite major advances in insulin delivery and glucose-monitoring technologies. Transplantation of primary islets or stem cell-derived β-like cells offers a promising route to physiological glycemic control; however, durable engraftment remains limited by complex immune rejection. Unlike classical solid organ transplantation, β-cell replacement in T1D confronts a uniquely intertwined set of immunological barriers, including innate inflammatory activation, adaptive alloimmunity, persistent humoral responses, and recurrent autoimmune memory, further exacerbated by as-yet undefined factors that disrupt the native islet microenvironment. These overlapping effector pathways help explain why single-axis immunosuppressive or physical shielding strategies have not achieved long-term protection. In this review, we synthesize current mechanistic insights into the immune processes that limit β-cell graft survival and organize emerging therapeutic strategies according to the rejection pathways they target. We discuss advances in graft-intrinsic immune engineering, local graft-adjacent immunomodulation, and systemic immune interventions aimed at mitigating innate inflammation, cellular and humoral immunity, and autoimmune recurrence. We further highlight translational progress, safety considerations, and regulatory challenges associated with these approaches. Collectively, this mechanistic perspective provides a rational framework for designing coordinated immunomodulatory strategies to enable durable, immune-compatible β-cell replacement for T1D.

Dexamethasone is typically included in the anti-emetic regimens during the administration of anticancer drugs. However, the incidence and severity of nausea and vomiting in patients receiving anticancer therapy, for whom dexamethasone must be avoided to prevent the recurrence of diabetes mellitus or hepatitis, remain unknown.

This retrospective, observational study evaluated nausea and vomiting in patients with breast cancer who underwent highly emetogenic chemotherapy, including anthracycline and cyclophosphamide, for breast cancer. In all patients, dexamethasone was completely omitted from the standard antiemetic regimen for reasons such as hepatitis, and only palonosetron and aprepitant were administered.

For the 82 evaluated cases, the incidence of nausea was 84.1%, vomiting was 14.6%, and the complete response (CR) rate was 8.5%. In addition, the incidence rate of grade 2 or higher nausea (CTCAE ver. 4) was 47.6%, and the proportion of cases in which anticancer drug doses were reduced in the subsequent course due to nausea and vomiting was 2.4%. Factor analysis showed that treatment regimens, age, drinking history, history of prior chemotherapy, and reasons for omitting dexamethasone had no significant effects on the incidence of chemotherapy-induced nausea and vomiting.

This study confirmed that the antiemetic effect of only administering palonosetron and aprepitant is insufficient for patients receiving highly emetogenic chemotherapy in whom dexamethasone cannot be administered. Prophylactic administration of other antiemetic drugs is necessary to effectively manage nausea and vomiting in patients receiving anticancer therapy who cannot receive dexamethasone.

Diabetic patients require long-term polypharmacy, yet the causal effects of these medications on ocular complications-specifically diabetic retinopathy (DR), diabetic maculopathy (DMac), and glaucoma-remain unclear due to confounding in observational studies.

We performed a Mendelian randomization (MR) study using GWAS summary statistics for 23 common medication classes and five diabetic eye diseases. Multivariable MR (MVMR) was employed to adjust for key comorbidities (e.g., hypertension, type 2 diabetes), while enrichment analyses explored biological mechanisms.

In the univariable MR (UVMR) analysis, drugs used in diabetes, agents acting on the renin-angiotensin system, and several other medication classes showed significant associations with increased risks of diabetic eye diseases. Crucially, MVMR confirmed robust causal links after adjusting for key comorbidities. Specifically, drugs used in diabetes remained associated with DMac (OR = 1.44, p = 1.31 × 10^-11), DR (OR = 1.23, p = 1.26 × 10^-8), neovascular glaucoma (OR = 1.19, p = 0.003), and senile cataract (OR = 1.10, p = 9.25 × 10^-12) independent of type 2 diabetes liability. Similarly, thyroid preparations retained significance for DMac (OR = 1.26, p = 4.35 × 10^-10), DR (OR = 1.17, p = 9.53 × 10^-10), and senile cataract (OR = 1.04, p = 0.004) after adjusting for hypothyroidism. Additionally, adrenergic inhalants were independently linked to senile cataract (OR = 1.07, p = 0.008) after adjusting for asthma. Pathway analysis highlighted hormone transport and MAPK signaling as potential mechanisms.

Our findings provide genetic evidence supporting potential comorbidity-independent causal links between specific systemic medications-particularly diabetes and thyroid drugs-and ocular complications, suggesting the importance of ophthalmological monitoring in these patients.