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.

Type 2 diabetes mellitus (T2DM) is prevalent in Nepal, with many seeking primary care through Ayurveda, a widely practiced traditional system. However, concerns exist about suboptimal care and variability in clinical practice among Ayurvedic practitioners. No evidence-based clinical practice guideline (EB-CPG) is available for managing T2DM. Therefore, an EB-CPG was developed, and a feasibility study was conducted to inform a future cluster randomized controlled trial (RCT) assessing whether EB-CPG improves T2DM management compared with usual practice.

A two-arm feasibility cluster RCT was conducted in Ayurveda centers. Centers were randomized (1:1) by an independent statistician. Adults with newly diagnosed, treatment-naïve T2DM and glycated hemoglobin (HbA1c) of 6.5%-< 9% were recruited. Data collectors and the analyst were blinded to group allocation.

Fourteen Ayurveda centers were approached, all recruited (seven/group) and completed the study. One center withdrew and did not enroll participants. Of 151 potential participants, 121 (80%) were recruited (60 in intervention and 61 in control). Of those, 84% were followed up to 6 months (51/group). The median adherence score to EB-CPG among practitioners was 1-2 (partial to adequate adherence). The median (interquartile range) number of EB-CPG-recommended medicines not consumed by participants and days without consumption was 0 (0-10) and 0 (0-2.5), respectively. No serious adverse events occurred. Preliminary estimates suggest EB-CPG's beneficial effects on HbA1c, fasting plasma glucose, and health-related quality-of-life, though not statistically significant.

This feasibility trial demonstrated successful recruitment, follow-up, and intervention adherence. A definitive trial is feasible to evaluate the intervention's effectiveness in T2DM management.

ClinicalTrials.gov Identifier: NCT05259735; first posted on March 02, 2022.

Type 1 diabetes (T1D) is a lifelong condition typically diagnosed in childhood. Clinical practice guidelines recommend comprehensive multidisciplinary team (MDT)-based care led by paediatric endocrinologists. However, experiences and opinions of health professionals about the implementation of T1D MDTs in Australia are currently unknown.

To describe health service teams caring for children and youth with T1D in Australia and to identify opportunities for service improvements from providers' perspectives.

Mixed-methods study co-designed with clinicians and consumers, including a survey of clinic leaders and semi-structured interviews. Survey questions covered modes of care delivery, team composition and outreach. Interview transcripts were thematically analysed using a hybrid inductive/deductive approach.

Thirty-two T1D services leaders completed the survey; 16 were from major cities and 16 were from regional/rural areas across all Australian states and territories. The services provided care for ~51% of all <19-year-olds living with T1D. T1D services were multidisciplinary and commonly included dieticians (n = 29, 94%), nurse diabetes educators (n = 22, 71%) and general paediatricians (n = 21, 68%). Eight (29%) services had a dedicated psychologist. A quarter (25%) of regional/rural services had a paediatric endocrinologist compared with 100% of major city services (χ² = 18.355; p < 0.001). All services offered telehealth consultations. Interviews revealed that services placed high value on having established cohesive teams skilled in T1D. Service leaders had concerns regarding workforce capacity and shortages, limited access to psychologists, inequitable access to insulin pumps and limited links with general practitioners.

This mixed-methods study is the first Australia-wide exploration of T1D models of care that describes care provision from the clinicians' perspectives. A need exists to address current gaps to achieve the recommended MDT models of care for T1D. Understanding existing models of care will be essential to determine the future impacts of changes in policies, therapies and demands on paediatric T1D services.

Despite the popularity of complementary and alternative medicine among older persons, its use within this subpopulation is still not fully understood. This study aimed to explore the perceptions of older persons residing in communities in Ebonyi State as pertains the use of complementary and alternative medicine.

Qualitative data collection was by focus group discussions (FGDs), in four communities, two urban and two rural, in Ebonyi state, Nigeria. A total of 12 FGDs involving 96 participants, each consisting of 8 males or females respectively were conducted using a synthesized FGD guide. A thematic analysis of data was performed with the aid of NVivo software.

The Leventhal's self-regulatory model (SRM) was utilised as it provides a flexible framework for understanding the use of complementary and alternative medicine among older persons. Majority of the participants expressed belief in the inherent benefits of complementary and alternative medicine, which were categorized into medical and non-medical reasons. Febrile illness, including malaria, typhoid fever, and hepatitis; respiratory; haematological; and dermatological conditions were reported as the common health conditions for which participants used CAM. Additionally, participants mentioned using CAM for chronic conditions, such as diabetes mellitus, hypertension, and arthritis, as well as for general health promotion and wellbeing. Preference for CAM was influenced by belief in its effectiveness, perceived lower cost when compared to conventional treatments, delays in hospital diagnoses and treatments, and belief in the spiritual origins of diseases. Safety concerns regarding CAM use included a lack of information on dosing, directions for safe use, and potential side effects.

The findings indicate a strong belief among participants in the benefits of complementary and alternative medicine which they believe offer both medical and non-medical advantages. However, despite these perceived benefits, safety concerns were also raised by some participants. Efforts to promote education and awareness about CAM, improve access to reliable information, and ensure the safe and effective use of CAM therapies are crucial for supporting the health and well-being of older persons who choose to incorporate CAM into their healthcare practices.

Clinical services for adults with early-onset type 2 diabetes (EOT2D) are in urgent need of improvement.

We evaluated a multi-disciplinary clinic for individuals with EOT2D at high risk (HbA1c >9%/triglyceride >20 mmol/L), providing 2-3 flexibly arranged consultations per individual between March 2024 and September 2025. Nurse-led case-finding in primary care supported identification and targeted referral of high-risk individuals. On 3 November 2025, electronic medical records were used to evaluate change in cardiometabolic outcomes at 6- and 12-months from baseline and evaluate service activity, including proportions with recorded health information and prescriptions. The paired t-test (continuous) and McNemar's test (proportions) were used to assess change in outcomes. Patient feedback was obtained using questionnaires.

In total, 159 individuals received an appointment (45% women; median age 34 years). At both 6- and 12-months post-baseline, HbA1c (at 12-months: -2.53% [95% CI: -3.13, -1.93]/-28 mmol/mol [-34, 21]), systolic (-5.89 mmHg [-9.88, -1.91]) and diastolic (-2.72 mmHg [-5.34, -0.10]) blood pressure, body mass index (BMI; -1.49 kg/m² [-2.31, -0.67]) and weight (-3.52 kg [-6.32, -0.72]) were significantly lower. Triglycerides were lower at 12-months only (-1.12 mmol/L [-1.89, -0.34]). The proportion with BMI or smoking status recorded, and with a glucagon-like peptide-1 receptor-based treatment, was higher at 12-months than at baseline, whereas creatinine and retinal screening measurements were less frequent. A limited amount of patient feedback was positive.

Case-finding and invitation to flexibly run multidisciplinary clinics were associated with improvements in cardiometabolic outcomes and positive patient feedback. Similar services are immediately required given the rising prevalence of EOT2D and associated complications.