The aim of this study was to explore the factors influencing type 2 diabetes mellitus (T2DM) among adults in Zhejiang Province.

A stratified cluster sampling technique was employed, and adults without known diabetes were included in the analysis. Food consumption was assessed using three consecutive days of 24-h dietary recall. Blood samples were collected to measure fasting blood glucose (FBG), blood lipids [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), 25-(OH)D vitamin D (VD), and vitamin A (VA). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured. Ordinal regression was used to explore factors influencing T2DM.

The analysis included a total of 5,804 adults. The prevalence rates of T2DM and prediabetes were 5.5 and 5.8%, respectively. Significant differences were observed in age, sex, nutritional status, hypertension, and blood lipid levels among adults with normal fasting blood glucose, prediabetes, and T2DM (p < 0.05). Adults aged 55 years and above, those who were overweight or obese, those with hypertension, and those with higher TG levels had a greater risk of developing diabetes (p < 0.05).

This study revealed that adults aged 55 years and above, those who are overweight or obese, those with hypertension, and those with higher TG levels have a greater risk of developing diabetes. These findings underscore the need for targeted interventions to manage these risk factors in the prevention and management of T2DM.

To investigate the serum levels of Chemokine CCL26 (CCL26) and Receptors, CCR3 (CCR3) in patients with Diabetes Mellitus, Type 2 (T2DM) complicated by lower extremity artery disease (LEAD), and to evaluate their potential as diagnostic biomarkers for T2DM with LEAD.

A retrospective study was conducted involving 197 patients with T2DM between June 2022 and February 2025. Patients were divided into T2DM group (n=157) and LEAD group (n=40). Clinical data and fasting venous blood were collected to measure serum CCL26 and CCR3 levels. Pearson correlation analysis was used to assess the correlation between CCL26 and CCR3. Lasso regression and logistic regression models were employed to identify risk factors for LEAD. The receiver operating characteristic (ROC) curve was constructed to evaluate the predictive efficacy of CCL26 and CCR3 for LEAD.

The LEAD group had significantly higher BMI, disease duration, HbA1C, FINS, and HOMA-IR compared to the T2DM group (P<0.05). Serum levels of CCL26 and CCR3 were elevated in the LEAD group (P<0.05). A positive correlation was found between CCL26 and CCR3 (r=0.337, P=0.034). Lasso regression identified 12 indicators, including CCL26 and CCR3, as predictors of LEAD. Logistic regression revealed that BMI, disease duration, HbA1C, CCL26, and CCR3 were independent risk factors for LEAD (P<0.05). The combined detection of serum CCL26 and CCR3 had an AUC of 0.812, indicating high predictive value for LEAD in T2DM patients.

Serum CCL26 and CCR3 levels are elevated in T2DM patients with LEAD and are closely associated with its occurrence. Combined detection of these biomarkers shows good predictive value for LEAD in T2DM patients.

The aim of this study was to investigate the predictive effects of the serum uric acid-to-albumin ratio (sUAR) on the onset of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

A case-control study was conducted involving 1809 patients with T2DM, including 486 cases with DKD and 1323 cases without DKD. Logistic regression and restricted cubic spline (RCS) analyses were used to analyze the relationship between the serum uric acid-to-albumin ratio (sUAR) and DKD. Receiver operating characteristic (ROC) curve was utilized to evaluate the predictive ability of the models for DKD. Decision curve analysis was performed to assess the clinical net benefit of the predictive models.

Multivariable logistic regression analysis revealed that sUAR was an independent risk factor for DKD (adjusted OR: 1.23, 95% CI: 1.16-1.30, P < 0.05). RCS analysis indicated a non-linear relationship between sUAR and DKD (P non-linear < 0.05). When sUAR exceeded 8.30, the risk of DKD gradually increased with higher sUAR. Additionally, combining sUAR with age, T2DM duration, glycated hemoglobin, systolic blood pressure, triglycerides, and high-density lipoprotein cholesterol significantly improved the predictive accuracy for DKD and the clinical net benefit.

High sUAR levels were the independent risk factor of DKD. Moreover, incorporating sUAR with traditional influencing factors enhanced the predictive value for DKD.

Gestational diabetes mellitus (GDM) is one of the most commonly diagnosed metabolic disorders in pregnancy, affecting between 5% and 20% of patients worldwide, depending on the diagnostic criteria and population. Although GDM pathogenesis is predominantly based on insulin resistance mechanisms resulting from the influence of pregnancy hormones, an increasing number of studies point to a significant role of immunological factors in the process of GDM development. In some GDM patients, autoantibodies targeting pancreatic beta cells are detected. Consequently, autoimmune processes may constitute an important element of GDM etiology, particularly in cases where GDM is a transitive condition leading to type 1 diabetes mellitus (T1DM) after the pregnancy. Disorders causing the destruction of beta cells within the pancreas precipitate permanent hyperglycemia in patients with autoimmune GDM (gestational diabetes mellitus with autoantibodies). characteristics. Genetic factors also play a significant role in this process, including single-nucleotide polymorphisms associated with the tissue compatibility system, such as HLA, CTLA-4, PTPN22 and IL2RA, which cause predisposition to T1DM. The following article discusses the current state of knowledge and presents GDM pathogenesis from the standpoint of immune mechanisms capable of affecting the development of this condition. It discusses potential markers that may help identify GDM patients at risk of progressing to permanent diabetes mellitus as well as possible diagnostic and therapeutic strategies based on the latest findings.

The increased life expectancy of people living with HIV (PLWHIV), due to the effectiveness of antiretroviral therapy, has been associated with a higher incidence of metabolic disorders such as dyslipidemia, insulin resistance, and adipose tissue redistribution. It has been demonstrated that the secretion of adipokines, particularly adiponectin, a key hormone in the regulation of inflammation and metabolism, is altered by these changes. This study it is intended to evaluate the HOMA-AD index and its correlations with metabolic, inflammatory, and obesity-related parameters.

Eighty participants were divided into five groups (PLWHIV, PLWHIV+preT2D, PLWHIV+T2D, PWT2D, and Controls). Clinical history, anthropometric data, and blood samples were collected to assess biochemical parameters. Adiponectin, hs-CRP, IL-6, IL-18, and IL-8 levels were quantified by ELISA. HOMA2-IR, HOMA2-%B, HOMA2-%S, HOMA-AD, and surrogate IR indices (TyG, TyG-BMI, TyG-WHtR, METS-IR, QUICKI) were calculated. Adiposity indices (VAI, DAI) and inflammatory markers (TG/HDL-C, NEU/HDL-C, MON/HDL, PLT/HDL, NLR, PLR) were also evaluated. Analyses were performed using IBM SPSS, GraphPad Prism, and RStudio.

The discrimination of T2D in PLWHIV was effectively achieved by the indices HOMA-AD, TyG-WHtR, QUICKI, and METS-IR, with AUC values reaching up to 0.9. Moderate correlations were identified between HOMA-AD and METS-IR (R = 0.58), TyG-WHtR (R = 0.53), QUICKI (R = -0.90), DAI (R = 0.45), and VAI (R = 0.44), as well as inflammatory markers hs-CRP (R = 0.30), IL-6 (R = 0.25), and IL-18 (R = 0.27). A cutoff point of HOMA-AD >1 was associated with a significantly increased risk for T2D in PLWHIV (OR = 15.4; 95% CI: 2.79-79.5), x (OR = 1.97), and non-HIV T2D populations (OR = 9.53). These results highlight the importance of HOMA-AD and inflammatory markers in glycemic risk stratification.

Our study demonstrates that the HOMA-AD index improves T2D detection in PLWHIV, likely due to its strong association with insulin resistance, systemic inflammation, and adiposity. It emerges as a promising tool to evaluate metabolic and inflammatory status in this population.

Diabetes is a prevalent chronic metabolic disorder, and the rising rates of this condition, along with its complications, significantly threaten public health. Traditional treatments for diabetes have certain limitations in practical applications, and it is particularly important to find new, effective treatments with fewer side effects. With a long history and rich experience, traditional Chinese medicine (TCM) effectively treats diabetes.

Data from randomized controlled trials concerning TCM and its effects on diabetes were gathered and analyzed from various databases. A meta-analysis was conducted on the 58 selected articles, and the potential mechanisms of action of the active ingredients in TCM were examined using network pharmacology techniques.

Meta-analysis of 58 randomized trials (n=7,318) demonstrated significant improvements in fasting glucose (MD=-0.53 mmol/L [-0.67,-0.39], P<0.00001), HbA1c (MD=-0.40% [-0.61,-0.20], P = 0.0001), and insulin resistance (HOMA-IR: MD=-0.90 [-1.51,-0.29], P = 0.004), alongside favorable lipid modulation (LDL: MD=-0.14 mmol/L, P = 0.0002). Network pharmacology revealed six core herbs (Astragalus membranaceus, Coptis chinensis, etc.) targeting 32 hub genes (AKT1, IL1B, PPARG, etc.) through three key pathways: insulin signaling (PI3K-AKT), inflammatory regulation (TNF/IL-17), and oxidative stress response (HIF-1/NRF2 axis). The polypharmacological effects were mediated by multi-component interactions involving quercetin, kaempferol, and stigmasterol.

TCM has demonstrated considerable effectiveness in managing diabetes. Through meta-analysis and network pharmacology research, this translational study establishes Level 1a evidence for TCM's antidiabetic efficacy while decoding its systems-level mechanisms. The integrated methodology provides a paradigm for evaluating complex herbal interventions in metabolic disorders.

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024572433.

Most endometrial cancer (EC) cases are estrogen-dependent, and some are associated with diabetes mellitus (DM). We aimed to estimate the risk of fracture among patients with EC and those with DM.

A total of 20814 patients with EC were identified from the Taiwan National Cancer Registry from 2007 to 2018, with the outcome ascertainment using the National Health Insurance Research Database from 2004 to 2019. This observational study investigated the hazard ratios (HRs) for fracture and mortality events using Cox proportional hazards regression, with 95% confidence intervals (CIs). We adjusted baseline comorbidities, cancer therapy, cancer staging and grade, and pathological status of estrogen receptor and progesterone receptor. Considering the competing death events, we estimated the subdistribution hazard model to predict the probability of the fracture risk in the competing risks context.

Among 15,505 EC patients, there were 3,044 patients with and 12,461 patients without DM. Patients with EC exhibited a no significant association of fracture when compared to the matched general population. EC patients with DM, compared to those without DM, had a significantly increased odds of osteoporotic fracture (HR 1.29 [95% CI 1.08-1.55]), hip fracture (HR 2.37 [95% CI 1.44-3.92]), and vertebral fracture (HR 1.71 [95% CI 1.06-2.74]). Patients with DM had a no significant association of upper extremity fracture (HR 1.33 [95% CI 0.95-1.87]) compared with those with EC but without DM.

EC patients had a no significant association of fracture, while DM increased the fracture risk in EC patients.

The prevalence of diabetes is increasing exponentially, accompanied by an increase in chronic complications, including nephropathy. Kidney transplantation may offer freedom from dialysis but adding a pancreas addresses the underlying disease. Type 2 diabetes mellitus (T2DM) is often described as a condition of insulin resistance and the concurrent beta-cell loss and dysfunction is potentially underestimated. The aim of this review was to provide a critical appraisal of simultaneous pancreas and kidney (SPK) transplantation in recipients with T2DM. The primary concern with SPK transplantation in this group is insulin resistance and the impact of obesity on outcomes. Multiple studies have shown comparable graft survival (GS), patient survival and complication rates when comparing T2DM and T1DM recipients. Furthermore, patients with T2DM had significantly improved GS with SPK when compared to kidney transplantation alone. Despite these findings, SPK transplantation is only selectively used in T2DM patients. Existing literature focuses on comparing transplant outcomes between patients with T1DM and T2DM. We believe the more relevant question is whether a patient with T2DM would derive a meaningful benefit from an SPK, and whether these benefits outweigh the risks, in the context of their other co-morbidities which are not completely similar to those associated with T1DM.

Longitudinal evidence of the relationship between blood pressure (BP) variability and end-stage kidney disease (ESKD) among individuals with type 2 diabetes is limited. Therefore, we evaluated the association between BP variability and ESKD in Korean adults with type 2 diabetes.

The study utilized data from the Korean National Health Insurance Service database, comprising health checkups conducted between 2004 and 2015. We enrolled 36 421 adults aged ≥ 19 years with type 2 diabetes who underwent at least two health checkups and were followed up until the end of 2017. BP variability was measured using the coefficient of variation, standard deviation, and variability independent of the mean. Hazard ratios (HRs) and 95% confidence intervals (CIs) for ESKD were determined using multivariate Cox proportional hazards regression analysis.

During a median follow-up of 8.05 years, 290 patients with ESKD were identified. The highest quartile of systolic or diastolic BP variability presented a higher risk of ESKD than did the lowest quartile of systolic or diastolic BP variability. The group with the highest systolic and diastolic BP variability had a 77% higher risk of ESKD than did those in the lowest three quartiles of both systolic and diastolic BP variability. These associations were present in younger individuals without comorbidities.

Among individuals with type 2 diabetes, increased BP variability was associated with an increased risk of ESKD. These associations were similarly observed in younger individuals without comorbidities. Maintaining a consistent BP seems to be important to prevent progression to ESKD in individuals with type 2 diabetes.

Disturbances in calcium (Ca), vitamin D, and electrolyte balance have been implicated in diabetic kidney disease (DKD), yet existing evidence remains inconsistent. Moreover, the role of albumin-corrected Ca-a more accurate measure of biologically active Ca in patients with frequent hypoalbuminemia-remains poorly defined in type 2 diabetes mellitus (T2DM). We aimed to investigate the association between albumin-corrected Ca, vitamin D, electrolytes and DKD in a large T2DM cohort.

In this cross-sectional study, 5550 T2DM patients were enrolled, including 1574 participants with DKD. Multivariable regression analyses were used to assess the association between albumin-corrected Ca, vitamin D and DKD. Spearman's correlation analyses were conducted to examine the correlation between electrolyte levels, vitamin D and indicators of renal impairment.

Patients with DKD in T2DM were older, predominantly male, with longer diabetes duration, higher blood pressure, poorly glycemic control and more diabetic complications compared to those without DKD. Notably, patients with DKD also showed significant electrolyte imbalances, suggesting dysregulated mineral metabolism. Multivariate logistic regression revealed albumin-corrected Ca (odds ratio [OR]: 4.032, 95% confidence interval [CI]: 2.017-8.062, P < 0.001), 1,25-(OH)₂-VitD₃ (OR: 0.967, 95% CI: 0.960-0.974, P < 0.001) were independently associated with DKD after accounting for confounding factors.

We demonstrated that elevated albumin-corrected Ca and decreased 1,25-(OH)₂-VitD₃ were significantly associated with DKD in T2DM patients. These findings suggest the potential of mineral metabolism parameters, particularly albumin-corrected Ca, to enhance early detection and risk stratification. Future prospective cohort studies are essential to establish a causal relationship and clarify their clinical therapeutic guidance value.