Diabetes is a chronic condition characterised by hyperglycaemia due to impaired insulin secretion, insulin action, or both. Oxidative stress reduces insulin sensitivity and contributes to complications. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common enzymatic disorder of erythrocytes, impairs NADPH production and reduces the ability to counter oxidative stress. Given the involvement of redox imbalance in diabetes pathogenesis, the role of G6PD deficiency in diabetes development and progression remains unclear. Two reviewers independently searched PubMed, Cochrane Library, and Embase to August 10th, 2026, for primary studies on G6PD deficiency and diabetes, resolving discrepancies by discussion. Forty-two studies met inclusion criteria. G6PD deficiency was more prevalent in T2DM patients than in the general population. Diagnostic complications, including artificially reduced HbA1c, were identified. Specific G6PD variants were associated with increased risk and severity of diabetes-associated retinopathy. G6PD deficiency was also linked to increased risk of myocardial infarction, stroke, and arterial stiffness. Consistent evidence indicates a higher risk of complications associated with G6PD deficiency and diabetes, though associations with diabetes onset remain inconsistent. Future research should investigate genetic stratification, oxidative stress biomarkers, and strategies to reduce morbidity.

Exocrine pancreatic abnormalities have been reported in type 2 diabetes mellitus (T2DM), but their clinical relevance remains uncertain. We assessed whether T2DM is associated with a clinically meaningful exocrine pancreatic phenotype.

Adults undergoing endoscopic ultrasound (EUS) for non-pancreatic indications were prospectively enrolled. Patients with known or suspected pancreatic disease were excluded. Non-diabetic controls were frequency-matched to patients with T2DM by sex and age. EUS abnormalities, pancreatic body diameter, elastography, faecal elastase-1 (FE-1), symptoms, GIQLI, PEI-Q and nutritional markers were compared using adjusted models. EUS was performed by endosonographers blinded to diabetes status.

We analysed 57 T2DM patients and 53 controls. EUS abnormalities were similar between groups (2.16 ± 1.97 vs 1.77 ± 2.02; p = 0.186), including ≥ 5 abnormalities (15.8% vs 13.2%; p = 0.701). Pancreatic body diameter, mean strain ratio, FE-1, GIQLI, PEI-Q and nutritional markers were comparable. Low FE-1 < 200 µg/g was not more frequent in T2DM (10.9% vs 18.0%). Early satiety and diarrhoea were more frequent in T2DM.

In this selected EUS-referred population without known or suspected pancreatic disease, T2DM was not associated with clinically relevant exocrine dysfunction, pancreatic atrophy or a coherent chronic pancreatitis-like EUS phenotype. These findings support phenotype-based pancreatic function testing in T2DM.

To assess the incidence of microvascular and macrovascular complications and mortality within three years after clinical diagnosis of type 2 diabetes mellitus (T2DM), and to identify associated risk factors.

In this retrospective population based study, 5773 individuals aged 40-90 years diagnosed with T2DM in Region Halland, Sweden between 2015 and 2020 were included. Data were obtained from a regional healthcare database, and individuals were followed individually from the date of diabetes diagnosis for three years or until death, whichever occurred first. The primary outcome was a composite of microvascular complications, macrovascular complications, and all-cause mortality. Associations between clinical factors and outcomes were analyzed using Cox regression.

Within three years, 36% of individuals developed complications and 4% died. Microvascular complications were more common than macrovascular events. In analyses of the composite outcome, impaired kidney function was associated with increased risk (hazard ratio [HR] 2.70, 95% confidence interval [CI] 2.08-3.52), as was poor glycemic control (HR 1.38, CI 1.19-1.59). Higher age increased risk, while female sex was associated with a lower risk.

A substantial proportion of individuals developed complications shortly after clinical diagnosis of T2DM. These findings highlight the importance of early assessment of glycemic control and kidney function for risk stratification and identification of individuals at increased risk of adverse outcomes.

Retropharyngeal abscesses (RPAs) are severe deep neck infections that require rapid intervention to prevent life-threatening complications. This study aimed to evaluate the clinical, laboratory, and radiological risk factors that predict the need for intensive care unit (ICU) admission and surgical drainage in adult patients with RPAs.

A retrospective review was conducted on patients treated for RPAs at our center between January 2013 and December 2023. Of the 64 initial cases, 57 adults were included in the final analysis after excluding pediatric patients and incomplete records. We analyzed the impact of demographics, diabetes mellitus (DM) status, admission laboratory markers (C-reactive protein [CRP], white blood cell [WBC] count), and radiological abscess size on the necessity for ICU admission and surgical intervention. Additionally, Receiver Operating Characteristic (ROC) curves were generated to assess the predictive value of these variables for ICU admission.

The cohort's mean age was 37.7 ± 16.7 years, with 9 patients (15.8%) requiring ICU care. Multivariate logistic regression identified DM (OR = 3.61, 95% CI: 1.31-9.92, p = 0.01), admission CRP level (OR = 1.01, 95% CI: 1.00-1.02, p = 0.03), and maximum abscess diameter (OR = 1.09, 95% CI: 1.02-1.18, p = 0.02) as independent predictors of ICU admission. ROC analysis for CRP yielded an area under the curve (AUC) of 0.87; a 200 mg/L cut-off achieved 100% sensitivity and 80.9% specificity. Maximum abscess diameter demonstrated an AUC of 0.81, with a 30 mm cut-off providing 88.9% sensitivity and 71.4% specificity. None of the evaluated parameters significantly correlated with the need for surgical drainage.

Comorbid DM, elevated CRP levels, and larger abscess dimensions independently predict the need for intensive care in adults with RPAs. The strong discriminative capacity of admission CRP and radiological abscess size highlights their critical utility in early clinical risk stratification and guiding targeted treatment strategies.

Gestational Diabetes Mellitus (GDM) is a growing public health concern in Ethiopia. HbA1c is useful for assessing glycemia but is influenced by physiological changes in pregnancy. To our knowledge, no published trimester-specific HbA1c reference intervals exist for Ethiopian non-diabetic pregnant women. This limits population-specific clinical interpretation.

A facility-based cross-sectional study was conducted from February to July 2025 among 424 non-diabetic pregnant women across all trimesters. Normality of HbA1c distribution was assessed using the Shapiro-Wilk and Kolmogorov-Smirnov tests; outliers were identified using Tukey's fences method. Reference intervals were determined parametrically (mean ±2SD). Differences across trimesters were tested using one-way ANOVA. Because Levene's test indicated a violation of the homogeneity of variances (p < 0.001) and group sizes were unequal, pairwise comparisons were performed using the Games-Howell post hoc test. A p-value < 0.05 was considered statistically significant.

HbA1c showed a normal distribution across all trimesters. Reference intervals were 4.8-5.9% in the first, 4.2-5.8% in the second, and 4.5-5.9% in the third trimester. Mean HbA1c levels differed significantly between trimesters (p < 0.05). Lowest in the second trimester 5.00% (95% CI 4.93-5.07) and highest in the first trimester 5.35% (95% CI: 5.31-5.39). Games-Howell post hoc tests confirmed that all pairwise comparisons were significant (p < 0.05).

Trimester-specific HbA1c reference intervals were defined for non-diabetic pregnant women, demonstrating measurable physiological variation across gestation. The use of locally derived thresholds could improve the accuracy of GDM screening and support more appropriate clinical interpretation.

Smoking and lifestyle‑related diseases increase the risk of cancer incidence and progression, but their impact on castration‑resistant prostate cancer (CRPC) remains unclear. This study examined whether diabetes mellitus (DM), hypertension (HT), and smoking habit (SH) affect the prognosis of CRPC patients treated with enzalutamide (ENZ) or abiraterone plus prednisolone (ABI).

Using data from the ENABLE study for PCa, an investigator‑initiated, multicenter, randomized controlled trial, patients were retrospectively categorized into two groups based on SH. Subsequently, the impact of the absence or presence of either DM or HT and treatment arm (ENZ or ABI) on survival endpoints was investigated.

A total of 178 patients were randomized and treated, of whom 161 had available SH information and were included in the analysis (84 SH- and 77 SH+). No significant differences in survival endpoints were observed between the SH- and SH+ groups. In the SH+ group, prostate cancer-specific survival (PCSS) was significantly worse in the with‑DM/HT group than in the no‑DM/HT group (p = 0.0215). Multivariate Cox analysis confirmed that the presence of DM or HT was an independent predictor of poor PCSS. Furthermore, a significant difference in PCSS between the no‑DM/HT and with‑DM/HT groups was observed in the ENZ arm (p = 0.0201), but not in the ABI arm.

SH does not appear to influence the efficacy of ENZ or ABI therapy for CRPC; however, among SH+ patients, the presence of DM or HT was associated with poorer survival outcomes, particularly in those treated with ENZ.

Type 2 diabetes mellitus (T2DM) significantly amplifies the risk and severity of myocardial ischemia-reperfusion (IR) injury, contributing to the disproportionately high cardiovascular mortality observed in diabetic patients. This study investigated the combined cardioprotective effects of sinomenine and liraglutide in a rat model of T2DM with myocardial IR injury and elucidated the underlying molecular mechanisms. Male Sprague Dawley rats were induced to T2DM with a high-fat diet and low-dose streptozotocin. After the induction of diabetes, the rats underwent 30 min of occlusion of the left anterior descending coronary artery, followed by 24 h of reperfusion. Before the IR procedure, diabetic rats were pretreated with sinomenine and/or liraglutide for 7 days. A comprehensive suite of techniques was employed to evaluate various endpoints, including echocardiographic and hemodynamic profiles, infarct size, histopathological alterations, cardiac troponin I (cTn-I) levels, pyroptosis-related proteins (NLRP3 and cleaved caspase-1), mitophagy-related markers (PINK-1 and Parkin), oxidative stress indicators (MDA, SOD, and GPx), and pro-inflammatory cytokines (IL-18 and IL-1β). The combination of sinomenine and liraglutide significantly improved cardiac function, reduced infarct size, attenuated histopathological damage, and decreased serum cTn-I levels (p < 0.05). It also downregulated the expression of pyroptosis-related proteins, upregulated the expression of mitophagy-related proteins, mitigated oxidative stress, and reduced pro-inflammatory cytokine levels (p < 0.05). The cardioprotective effects of the combined therapy were largely abrogated by pretreatment with mitochondrial division inhibitor 1. The combination of sinomenine and liraglutide showed remarkable cardioprotective effects against IR injury in diabetic rats, which were associated with the the attenuation of NLRP3-driven pyroptosis and the enhancement of PINK-1/Parkin-mediated mitophagy, suggesting a mechanistic link warranting further validation.

To investigate the long-term renal effects of tofogliflozin, with the shortest half-life among sodium-glucose cotransporter 2 inhibitors, in real-world clinical practice.

We retrospectively enrolled patients with type 2 diabetes mellitus treated at three affiliated hospitals between January 2015 and May 2024. The primary outcome was the change in estimated glomerular filtration rate from baseline to 72 months. After inverse probability of treatment weighting, linear mixed-effects models were used to compare estimated glomerular filtration rate changes between the tofogliflozin and non-tofogliflozin groups. As a sensitivity analysis, multiple imputation was performed to address missing baseline urinary albumin-to-creatinine ratio data. Secondary outcomes included estimated glomerular filtration rate slopes, changes in glycated hemoglobin and body weight at 72 months, and changes in urinary albumin-to-creatinine ratio at 48 months.

Among 598 participants (tofogliflozin, n = 245; non-tofogliflozin, n = 353), estimated glomerular filtration rate decline was significantly slower in the tofogliflozin group than in the non-tofogliflozin group (P < 0.001). At 72 months, the least squares mean estimated glomerular filtration rate change was -4.51 and -10.64 mL/min/1.73 m², respectively (between-group difference: 6.14 mL/min/1.73 m²). Significant between-group differences were observed in estimated glomerular filtration rate slope, glycated hemoglobin, and body weight, but not in urinary albumin-to-creatinine ratio. Renal findings were consistent in the multiple imputation sensitivity analysis.

Real-world clinical data over 72 months suggested that tofogliflozin may slow estimated glomerular filtration rate decline.

Atherosclerosis is a systemic vascular disease that can affect visceral arteries, including the superior mesenteric artery (SMA), potentially leading to mesenteric ischemia with high morbidity and mortality rates. Despite its clinical importance, SMA involvement remains under-reported. This study aimed to evaluate the prevalence, morphological characteristics, anatomical distribution, and associated risk factors of SMA atherosclerotic plaques using multidetector computed tomography (MDCT).

This retrospective study was conducted using data collected from a University Hospital in Turkey. This study focused on patients referred to the Department of Radiology and examined imaging data obtained between January 2008 and December 2010. Information was gathered by examining MDCT scans, patient reports, laboratory findings, and medical records of 15,000 patients admitted to our University Hospital over a designated period. The anatomical distribution of the aneurysms within the SMA (proximal, middle, distal, or diffuse) was recorded. The presence of concomitant atherosclerosis in other visceral arteries and cardiovascular risk factors, including hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), and abnormal lipid profiles, was evaluated. Statistical analysis was performed using SPSS (Version 10.0), and associations were assessed using Pearson's chi-square test, with a significance level set at p < 0.05.

The prevalence of SMA atherosclerosis was 0.86% in the studied population. Clinical data were available for 102 patients in this study. HT, DM, and CAD were present in 73.5%, 49%, and 44.1% of the patients, respectively. Calcified plaques were the most common type (55.8%), followed by mixed (28.7%) and soft plaques (15.5%).Plaques were predominantly located in the proximal (29.4%) and proximal-middle (22.4%) segments of the SMA, followed by the middle (14.7%), middle-distal (14.7%), distal (4.6%), and diffuse segments (13.9%). All patients demonstrated concomitant abdominal aortic atherosclerosis. Atherosclerotic involvement of other visceral arteries was frequently observed in this study. The renal arteries were the most commonly affected, with bilateral involvement in 49.2% of the patients and unilateral calcified plaques in 23.4% of the patients. Celiac trunk atherosclerosis was detected in 41.8% of patients, splenic artery involvement in 12.4%, and inferior mesenteric artery (IMA) involvement in 27.1%, making it the least affected artery. Lipid profile analysis revealed elevated total cholesterol levels in 38% of the patients and low HDL levels in 25% of the patients although no significant correlation was found between lipid levels and plaque characteristics or distribution.

Contrast-enhanced MDCT is a reliable, noninvasive imaging modality for detecting and characterizing SMA atherosclerosis, allowing for an accurate assessment of plaque morphology, distribution, and associated vascular involvement. Although relatively uncommon, SMA atherosclerosis is strongly associated with systemic atherosclerotic disease and major cardiovascular risk factors. Routine evaluation of mesenteric vessels during abdominal CT examinations may facilitate early diagnosis and improve clinical outcomes by enabling timely management of patients at risk for mesenteric ischemia.

To investigate clinical characteristics, comorbidities, seasonal onset, and antihypertensive medication use among acute primary angle-closure (APAC), chronic primary angle-closure glaucoma (CPACG), and primary angle-closure suspect (PACS) patients.

A retrospective cross-sectional study of 484 Chinese patients was conducted. Baseline demographics, hypertension and diabetes prevalence, antihypertensive medication use, and seasonal onset patterns were compared across primary angle-closure disease (PACD) subtypes. Seasonal variation was assessed using the von Mises distribution, with subgroup analyses stratified by systemic conditions and medication use.

CPACG patients were older (median 71 vs 67y in APAC, P<0.001) with higher hypertension (47.74% vs 31.16%, P=0.003) and diabetes prevalence (20.60% vs 10.05%, P=0.014). Multivariate analysis showed hypertension [odds ratio (OR)=1.85] and diabetes (OR=2.00) were significant predictors of CPACG vs APAC. A modest but significant seasonal peak of APAC onset was identified in early June. Subgroup analyses revealed significant shifts in seasonal patterns according to hypertension (P=0.023), diabetes (P<0.001), and calcium channel blocker (CCB) use (P=0.025). Angiotensin-converting enzyme inhibitors (ACEIs) use was absent in APAC patients but present in CPACG and PACS groups; CCB use was highest in APAC patients, though differences were not statistically significant.

Vascular and metabolic comorbidities are more prevalent in CPACG than APAC, suggesting their role in CPACG pathogenesis. The early-summer peak in disease onset points to possible environmental triggers. Seasonal variation in APAC onset appears to be influenced by systemic vascular conditions and antihypertensive medication use, supporting a multifactorial interaction between environmental, systemic, and pharmacologic factors in APAC.