Diabetic nephropathy (DN) is one of the most common microvascular complications of type 2 diabetes mellitus (T2DM) and a leading cause of chronic kidney disease worldwide. Inflammatory pathways play a key role in the pathogenesis and progression of DN. Interleukin-8 (IL-8), a pro-inflammatory cytokine involved in leukocyte recruitment and activation, has been associated with renal inflammation and albuminuria. However, the contribution of IL-8 gene polymorphisms to susceptibility and progression of DN remains unclear.

This cross-sectional case-control study included 138 patients with T2DM and 138 age- and sex-matched healthy controls. Diabetic patients were stratified according to the presence of DN based on urinary albumin excretion and diabetic retinopathy. Genomic DNA was isolated from peripheral blood samples, and the IL-8 rs4073 -251T>A polymorphism was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Genotype and allele frequencies were compared between groups, and clinical and laboratory parameters were evaluated according to genotype status.

Genotype distributions of the IL-8 rs4073 -251T>A polymorphism were similar between T2DM patients and controls, suggesting no association with the development of T2DM. Among diabetic patients, however, the AA genotype was detected only in individuals without nephropathy and was absent in both latent and overt DN groups. Patients lacking the AA genotype demonstrated higher urinary albumin excretion and a greater frequency of nephropathy progression. DN patients also exhibited longer diabetes duration, poorer glycemic control, impaired renal function, and elevated inflammatory markers compared with patients without nephropathy. Additionally, an inverse relationship between the presence of the A allele and leukocyte and neutrophil counts was observed.

The IL-8 rs4073 -251T>A polymorphism does not appear to influence susceptibility to T2DM; however, the presence of the A allele may exert a protective effect against the development of diabetic nephropathy. This protective effect may be mediated through modulation of inflammatory pathways, as suggested by the inverse association between the A allele and inflammatory cell counts. Larger multicenter studies are required to confirm these findings.

Urolithiasis is a recurrent metabolic condition associated with obesity, metabolic syndrome, and type 2 diabetes (T2D), yet the relationship between modern antidiabetic drug classes and stone risk remains incompletely defined. This systematic review aimed to evaluate comparative clinical-event evidence on sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), and dipeptidyl peptidase-4 inhibitor (DPP-4i) in relation to incident, recurrent, or severe urolithiasis outcomes.

This systematic review (PROSPERO ID: CRD420261366483) was reported according to PRISMA 2020. The PICO framework was: (P) adults receiving antidiabetic pharmacotherapy; (I) SGLT2i use; (C) GLP-1 RA, DPP-4i, or other active antidiabetic therapies; and (O) incident, recurrent, or severe urolithiasis events. MEDLINE, Embase, Cochrane CENTRAL, and Scopus were searched from inception through April 2026, with additional studies identified through reference-list screening. Risk of bias was assessed using ROBINS-I. Findings were synthesized narratively.

Six comparative clinical-event studies met inclusion criteria. All were observational studies using active antidiabetic comparators. Across studies, SGLT2i use was consistently associated with lower urolithiasis risk compared with GLP-1 RA or DPP-4i vs. GLP-1 RA, SGLT2i were associated with lower incident and recurrent urolithiasis outcomes, with hazard ratios (HRs) ranging from 0.51 to 0.69 and rate ratios from 0.58 to 0.82 vs. DPP-4i, SGLT2i were associated with lower incident, recurrent, and procedure-requiring stone outcomes, with HRs ranging from 0.33 to 0.84 and rate ratios from 0.63 to 0.73. The absolute risk reduction appeared greatest among patients with prior or recently active urolithiasis. All included studies were judged to have moderate overall risk of bias.

SGLT2i use was consistently associated with lower incident, recurrent, and procedure-requiring urolithiasis risk vs. GLP-1 RA or DPP-4i. Absolute risk differences were greatest among patients with prior or recently active urolithiasis. Given the observational evidence and moderate risk of bias, prospective studies with prespecified stone outcomes are needed.

Gastrointestinal complications of heart failure are increasingly recognized, but the epidemiology and clinical significance of gastroparesis in this population remain poorly defined. We evaluated a national multicenter cohort of adults with heart failure to characterize temporal trends in gastroparesis incidence, identify factors associated with its development, and assess its association with clinical outcomes. We used a national multicenter database to identify adults diagnosed with heart failure from 2005 to 2025. Temporal trends in gastroparesis incidence were evaluated at 5-year intervals, multivariable Cox proportional hazards regression was used to identify factors associated with its development, and 5-year cardiorenal and healthcare utilization outcomes were compared between patients with and without gastroparesis. Among 3,913,826 patients with heart failure, gastroparesis incidence increased more than tenfold during the study period, from 35.6 to 402.3 cases per 100,000 person-years. Diabetes mellitus [hazard ratio (HR) =4.54], chronic mesenteric ischemia (HR =2.16), ascites (HR =1.55), and heart failure with preserved ejection fraction (HR =1.60) were independently associated with gastroparesis. Patients with concomitant gastroparesis experienced significantly higher risks of major adverse cardiovascular events (MACE) [31.8% vs. 19.7%; odds ratio (OR) =1.90; 95% confidence interval (CI): 1.80-1.99; P<0.001], acute kidney injury, end-stage renal disease, emergency department visits, and intensive care unit admission (38.9% vs. 22.6%; OR =2.19; 95% CI: 2.11-2.27; P<0.001). These findings identify gastroparesis as an increasingly recognized comorbidity in patients with heart failure that may represent a high-risk phenotype. The observed associations further suggest that venous congestion and impaired splanchnic perfusion may contribute to the development of gastric dysmotility in this population.

Efforts to improve self-efficacy in patients with diabetes can play an effective role in improving treatment outcomes. Therefore, the present study was conducted to determine the effect of teach-back education on patients' self-efficacy in diabetic foot ulcer care.

In this quasi experimental study, 54 patients with diabetic foot ulcers referred to the diabetes clinic in the city of Saghez City, Iran, in 2023 were selected by a convenience sampling method and then randomly assigned to intervention and control groups. In the intervention group, teach-back education was implemented in four 45-minute sessions according to a structured program. The Diabetic Foot Care Self-Efficacy Scale was used to measure self-efficacy before and 30 days after the intervention in both groups. Data were analyzed using Mann-Whitney, Chi-square, Fisher's exact, and Wilcoxon tests using SPSS version 17.

According to the results, the intervention and control groups were homogeneous in terms of demographic characteristics and levels of self-efficacy before the intervention (p < 0.001). However, after the intervention, the self-efficacy level for diabetic foot ulcer care increased in both groups (p < 0.001). However, the mean difference in self-efficacy score was significantly higher in the intervention group compared to the control group (p < 0.001).

The present study showed that the teach-back educational method can increase self-efficacy for diabetic foot ulcer care among patients. Therefore, it is recommended to use teach-back education in the educational programs of medical centers to improve the self-efficacy of patients with diabetic foot ulcers.

Although transplantation is considered a treatment for end-stage renal disease, data on post-transplant outcomes remain fragmented.

This study aims to assess the outcomes of renal transplantation in Africa.

Studies were searched in MEDLINE, EMBASE, CINAHL, Scopus, Google Scholar, the Transplantation Library, and African Journals Online. A random-effects model was employed to calculate the pooled effect size of each outcome. Heterogeneity was assessed with the I ² test, and publication bias was evaluated using Egger's regression test. Trim-and-fill analysis was employed to manage publication bias. The protocol was registered in the International Prospective Register of Systematic Reviews.

Studies conducted in Africa.

In this study, 16 articles were included, with a total of 3617 participants.

Pooled mortality among renal transplant recipients was 14.3% (95% CI: 8.77%-19.84%). Graft survival rates at 1 and 5 years were 91.74% (95% CI: 88.56%-94.93%) and 69.15% (95% CI: 57.39%-80.91%), respectively. Patient survival at 1 and 5 years was 94.72% (95% CI: 92.17%-97.26%) and 81.26% (95% CI: 72.11%-90.4%), respectively. Diabetes mellitus, delayed graft function, acute rejection, and infection were observed as post-transplantation complications.

With a few important exceptions, both graft and patient survival were comparable to reports from other nations. Thus, we recommend that clinical practitioners prioritize infection prevention and early screening for complications. Furthermore, policymakers should develop and implement strategies to prevent and screen for post-transplant complications, and improve the accessibility of the service.

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) were approved by the United States Food and Drug Administration (FDA) for the treatment of type 2 diabetes mellitus (T2DM) in children aged 10 years and older on June 20, 2023. We describe SGLT2i prescribing trends among all specialties at a quaternary care pediatric medical center surrounding the approval of empagliflozin, then identify characteristics of patients with T2DM associated with a higher likelihood of SGLT2i prescription by pediatric endocrinologists.

We compared the total number of new SGLT2i prescriptions sent by all specialties before and after FDA approval of empagliflozin, between July 1, 2022, and June 30, 2024. We then identified children aged 10 years and older with T2DM who were newly prescribed an SGLT2i by pediatric endocrinologists. Demographic and clinical characteristics were compared with those of children with T2DM not prescribed SGLT2i.

The number of SGLT2i prescriptions sent by pediatric endocrinologists increased, and the top prescribing specialty shifted from Cardiology to Endocrinology. Increasing glycosylated hemoglobin (HbA1c) was associated with higher odds of SGLT2i prescription (OR 1.2 [95% CI, 1.1-1.3]; p < 0.001) regardless of empagliflozin approval status, low-density lipoprotein cholesterol, or urine microalbumin/creatinine ratio. Those prescribed SGLT2i before FDA approval were older, male, more frequently on insulin, and less frequently on metformin. These differences between groups were not seen post-approval.

SGLT2is were more likely to be prescribed for youth with higher HBA1c by pediatric endocrinologists. The presence of risk factors for cardiovascular or renal disease was less important in the decision to prescribe SGLT2i, despite their reno- and cardioprotective effects in adults. Prospective and qualitative data would be useful in further understanding prescribing practices.

Cardiovascular disease and chronic kidney disease are the principal drivers of morbidity and mortality in type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiorenal benefits in landmark trials, yet cross-trial inconsistencies in cardiovascular mortality, renal endpoints and drug-specific effects leave the class-level estimates incompletely synthesized.

PubMed, Web of Science, Scopus and CENTRAL were searched from inception through 15 May 2026. Large placebo-controlled RCTs (≥ 1000 participants) and prespecified subgroup analyses in adults with T2DM were eligible. The primary outcome was the composite of first hospitalization for heart failure (HHF) or cardiovascular death (CV death). Secondary outcomes were 3-point major adverse cardiovascular events (MACE), CV DEATH, myocardial infarction (MI), stroke, first HHF and composite kidney outcomes. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using random-effects inverse-variance models.

Fourteen studies (76 969 patients; 41 761 SGLT2i, 35 208 placebo) were included. SGLT2i reduced the primary composite by 23% (HR: 0.77, 95% CI: 0.73-0.81, p < 0.0001; I² = 0%), with no effect modification by baseline HF (p-interaction = 0.82) or established ASCVD (p-interaction = 0.46). MACE was reduced by 14% (HR: 0.86, 95% CI: 0.81-0.92), driven by significant reductions in CV DEATH (HR: 0.86, 95% CI: 0.79-0.93) and MI (HR: 0.88, 95% CI: 0.81-0.96), with no significant effect on stroke (HR: 0.93, 95% CI: 0.81-1.08). First, HHF was reduced by 29% (HR: 0.71, 95% CI: 0.66-0.77) and composite kidney outcomes by 31% (HR: 0.69, 95% CI: 0.60-0.79).

SGLT2i confer consistent and clinically meaningful cardiorenal protection in T2DM across the full spectrum of cardiovascular and renal risk. The ertugliflozin estimate and the moderate heterogeneity in kidney outcomes should be interpreted in the context of trial-level clinical differences and nonstandardized kidney endpoint definitions. These findings support proactive, guideline-concordant initiation of evidence-based SGLT2i agents by endocrinologists, cardiologists and primary care providers as foundational therapy in T2DM.

The increased risk of developing type 2 diabetes mellitus (T2DM) in the decade following childbirth among women with gestational diabetes mellitus (GDM) warrants early intervention. A prespecified update of a systematic review and meta-analyses published in 2024 was performed, examining the efficacy of interventions to prevent T2DM among women within 5 years of a GDM-affected pregnancy.

An updated search on PubMed, EMBASE and Web of Science (PROSPERO: CRD4202127989) was conducted on 14 November 2024. The primary outcome was T2DM diagnosis or measures of dysglycaemia with at least 12 months follow-up in women within 5 years of a GDM-complicated pregnancy. A Bayesian approach was adopted with results reported as effect sizes with 95% credible intervals (95% Crl), and posterior probabilities of intervention effectiveness.

Nine new publications were identified in this updated search, resulting in a total of 26 publications from 25 studies (n = 7379) included. Of those, four studies involved a pharmacological intervention and 21 evaluated lifestyle interventions. There was a 15% (95% CrI: 0.69-1.04) and 32% (95% CrI: 0.40-1.07) reduction in risk and hazard ratio for T2DM, respectively, with high posterior probabilities (95.0% and 96.0%, respectively). Reductions were observed for other secondary metabolic outcomes (fasting plasma glucose, body mass index, HOMA-IR and total cholesterol).

Compared to the original review, this update indicates greater certainty of the efficacy of preventive interventions for T2DM in women delivered during the first 5 years after a GDM-affected pregnancy. Evidence on the efficacy and safety of pharmacotherapy interventions is still limited.

The glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are a relatively new class of drugs that were initially approved by the US Food and Drug Administration to improve glycemic control in patients with type 2 diabetes mellitus and, subsequently, weight reduction in patients with obesity. Multiple sclerosis (MS) is commonly associated with comorbidities for which GLP-1RAs are indicated. An increasing prevalence of comorbid chronic diseases has increased the number of people living with MS (pwMS) who are prescribed a GLP-1RA, for indications of obesity, diabetes, obstructive sleep apnea, metabolic-associated steatohepatitis, and/or chronic kidney disease. This review addresses the following key considerations: (1) the use of GLP-1RAs for weight loss in pwMS and obesity, including considerations related to drug tolerability and safety; (2) the efficacy of the GLP-1RAs for their approved non-MS indications in pwMS; and (3) the potentially pleiotropic effects of the GLP-1RAs on the MS disease course beyond their approved indications.

Women with extremely dense breasts have an increased risk of breast cancer but also a decreased sensitivity of mammography. The Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial, initiated in 2011, showed that supplemental full-protocol MRI screening reduced the number of interval cancers in women with extremely dense breasts. Cost-effective screening scenarios have been described, but imaging costs and capacity remain barriers to implementing full-protocol MRI in population-based breast cancer screening programs. Therefore, the DENSE-2 trial was set up to investigate two alternate screening techniques, contrast-enhanced mammography (CEM) or abbreviated MRI (AB-MRI), that are expected to be cheaper and to make more efficient use of the available capacity while potentially achieving similar results to full-protocol MRI. DENSE-2 is a multicenter randomized controlled trial embedded in the Dutch screening program. It comprises two consecutive screening rounds in which women receive the same breast imaging technique both times. The trial investigates the value of supplemental screening with CEM or AB-MRI in women with extremely dense breasts with a negative screening mammogram. The primary aim is to determine whether these methods will lead to a reduction of interval cancers compared with mammography. The DENSE-2 trial results will provide insights into the performance, feasibility, and acceptability of both screening modalities, enable long-term outcome modeling, and support decision-making on the most appropriate screening strategy for women with extremely dense breasts. ClinicalTrials.gov: NCT06636370 © RSNA, 2026 Supplemental material is available for this article. See also the editorial by Bahl in this issue.