As the global prevalence of diabetes continues to rise, approximately 19% to 34% of diabetes patients will develop chronic wounds or ulcers, which significantly impacts the quality of life of these patients and also imposes a heavy economic burden on the global healthcare system. The traditional treatment methods (debridement, antibiotics, regular dressing changes, hyperbaric oxygen therapy, etc.) are facing numerous challenges, including the increasing problem of bacterial resistance, high treatment costs, and poor long-term efficacy. Therefore, developing efficient and safe new treatment strategies for diabetic wounds has become a current research hotspot. Polysaccharide-based self-healing hydrogels (PSHs) have become one of the most promising wound dressings due to their excellent self-healing ability, good biodegradability, biocompatibility, and multiple biological activities. Unfortunately, there are still limitations in the research on PSHs in the field of diabetes wound treatment. Firstly, this review comprehensively introduces the types of polysaccharides with therapeutic effects on diabetic wounds and their excellent properties. Subsequently, this article systematically reviews the self-healing mechanisms of PSHs and the therapeutic strategies for diabetic wounds. Finally, this paper reviews the challenges and future prospects of PSHs in the clinical transformation of diabetic wounds. The results provide an important reference for the application of PSHs in the field of diabetes wound treatment.

Background and objective Tuberculosis (TB) and diabetes mellitus frequently co-occur in India and complicate the management of both conditions. Nevertheless, there is limited evidence on adherence to antidiabetic therapy among adults receiving TB care at district-level public health facilities. This study aimed to assess the levels of medication adherence and identify patient-reported barriers among adults with TB and diabetes attending two TB facilities in Ratlam district, Madhya Pradesh, India. Methods The facility-based cross-sectional descriptive study was derived from a parent research project conducted between January 2023 and December 2023 at the District Tuberculosis Centre and the TB Clinic of Government Medical College, Ratlam. Consenting adults aged over 18 years with newly diagnosed TB and coexisting diabetes were eligible. A pretested, structured questionnaire containing adherence and self-management items was used to collect data, and the current manuscript presents descriptive statistics. Results Out of the 135 respondents, 88 (65.2%) were men. The largest age group was 61 to 70 years (41.5%). Adherence to antidiabetic therapy was found to be low (80 participants, 59.3%), moderate (35 participants, 25.9%), and high (20 participants, 14.8%). Financial constraints (36.1%), medication side effects (26.2%), and the complexity of treatment regimens (18.3%) were the most commonly reported barriers to adherence. The majority of the participants received antidiabetic medicines in government institutions (78.5%). Conclusions The lack of adherence to antidiabetic therapy was widespread among adults with TB and diabetes in this setting. The most common barriers reported were financial barriers, adverse effects, and regimen complexity. These results support the need for improved adherence measurement and practical assistance in combined TB-diabetes care, and larger analytical studies are needed to identify independent determinants of nonadherence.

The objective of this review is to synthesize existing qualitative evidence on the experiences and perceptions of caregivers caring for children and adolescents with type 2 diabetes mellitus (T2D).

The rising number of new cases of T2D in children and adolescents highlights the urgent need for effective management strategies. Caregivers of these children face significant challenges in providing care and managing the condition.

This review will include caregivers of children and adolescents with T2D, regardless of age, gender, social status, or marital status. It will consider studies that explore caregivers' experiences and perceptions of caring for children and adolescents with T2D in home, school, and community settings, as well as those addressing treatment adjustments and peer responses within the school environment. Caregivers of children and adolescents with other types of diabetes, such as type 1 diabetes mellitus (T1D), will be excluded.

This qualitative systematic review will follow JBI methodology. We will search both published and unpublished studies in Embase (Ovid), MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Library (CENTRAL), LILACS (BVS), PsycINFO (Ovid), Web of Science Core Collection, and Scopus without date limitations. Sources of unpublished studies and gray literature include Google Scholar and the Open Access Theses and Dissertations (OATD). Two independent reviewers will assess methodological validity. The standardized JBI data extraction tool will be used for data extraction. Data will be synthesized using meta-aggregation, and a certainty of findings will be determined using the ConQual approach.

PROSPERO CRD420251116139.

Gestational diabetes mellitus (GDM) is associated with various perinatal complications and may affect neonatal acid-base status. Umbilical cord arterial blood gas (ABG) analysis provides an objective measure of fetal well-being at birth, although existing evidence on the impact of GDM on ABG parameters remains inconclusive. The objective of the study is to compare umbilical cord ABG parameters-pH, partial pressure of carbon dioxide (pCO₂) and partial pressure of oxygen (pO₂), base excess and bicarbonate-between pregnancies with and without GDM complications, and to evaluate the potential influence of GDM on neonatal oxygenation and acid-base balance. This single-center prospective-retrospectivecohort study was conducted in a tertiary care hospital in northern Poland and included 191 pregnant women (44 with GDM, 147 without). GDM was diagnosed based on International Association of Diabetes and Pregnancy Study Groups, World Health Organization, and national guidelines. Arterial cord blood samples were collected immediately after birth and analyzed for ABG parameters. The newborns of mothers with GDM had significantly higher pH values and significantly lower pCO₂ levels compared to the controls. No significant difference was observed in pO₂, base excess and bicarbonate values between the groups. These findings suggest that, in well-managed pregnancies, GDM may not lead to impaired fetal oxygenation or acidosis at birth. Our findings are consistent with the hypothesis that effective glycemic control and standardized perinatal care may mitigate the risk of neonatal acid-base disturbances. Further studies are warranted to explore the role of treatment modalities and delivery factors in shaping neonatal outcomes.

Obesity is a highly prevalent disease that significantly impacts quality of life and life expectancy. Over the past decades, bariatric surgery has become the gold standard for treating obesity and its comorbidities. In 2006, Santoro et al. described the technique of intestinal transit bipartition (ITB) to enhance neuroendocrine mechanisms of weight loss while minimizing nutritional deficiencies common in other procedures. The objective was to describe the first case of ITB performed in a high specialty center as a surgical treatment for obesity.

A 44-year-old male patient with grade III obesity and comorbidities, including type 2 diabetes mellitus and obstructive sleep apnea. The patient underwent ITB combined with sleeve gastrectomy. During follow-up, a significant reduction in body weight was observed (%EWL of 94.9% at 6 months), without alterations in biochemical parameters such as albumin, hemoglobin, or vitamin D levels. The procedure was safe, with no surgical or postoperative complications.

ITB is a promising surgical technique for the treatment of obesity and its comorbidities, with results comparable to other bariatric procedures. Its neuroendocrine effect favors metabolic control and significant weight loss, while limiting nutritional complications. Initial results highlight its safety and feasibility as a therapeutic alternative, although long-term studies are required to confirm its sustained impact on metabolic health.

Accurate quantification of islet mass is critical for the preclinical evaluation and therapeutic application of stem cell-derived pancreatic islet organoids. Traditional methods, including Ricordi's islet equivalent (IEQ) approach and its equivalent circle diameter adaptations, often overestimate islet volume due to reliance on maximal diameters and discrete size bins. To address these limitations, we developed an automated image segmentation and three-dimensional modeling framework to quantify individual islet clusters from brightfield images. Clusters were fitted with ellipses and modeled as ellipsoids using rotation about either the minor or major axis, allowing IEQs to be calculated continuously relative to a reference 150 μm spherical islet. Major-axis (prolate) rotation provided the most conservative and physically plausible volume estimates, whereas minor-axis (oblate) rotation and diameter-based approaches systematically overestimated IEQs. Functional assessment with glucose-stimulated insulin secretion assays across multiple size categories demonstrated consistent insulin output for clusters below 250 μm, supporting the reproducibility of our 3D differentiation system. In vivo, streptozotocin-induced diabetic mice transplanted with islet doses based on major-axis modeling exhibited faster and more stable restoration of glycemia compared with groups receiving doses derived from overestimated approaches. These findings establish that major-axis ellipsoid modeling offers a mathematically consistent, conservative, and biologically relevant method for estimating IEQs, providing a practical framework to guide dosing in preclinical studies and supporting the translational development of stem cell-derived islet therapies.

Objectives Patients with diabetic kidney disease (DKD) are at increased risk of cognitive impairment, but the underlying alterations in resting-state BOLD-CBF coupling remain unclear. This study aimed to investigate changes in resting-state BOLD-CBF coupling and their associations with clinical characteristics and cognitive function in DKD. Resting-state functional MRI (rs-fMRI) and arterial spin labeling (ASL) were performed in 36 patients with DKD, 36 patients without DKD, and 37 healthy controls. Amplitude of low-frequency fluctuations (ALFF) derived from rs-fMRI and cerebral blood flow (CBF) derived from ASL were used to calculate the ALFF-CBF coupling coefficient, which was used to characterize resting-state BOLD-CBF coupling. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) before MRI examination. Laboratory tests were also performed, and correlations with clinical variables and MoCA scores were analyzed. Compared with the non-DKD group, the DKD group showed significantly reduced resting-state BOLD-CBF coupling in several brain regions. In the DKD group, glycated hemoglobin A1c levels negatively correlated with resting-state BOLD-CBF coupling in the bilateral medial superior frontal gyrus, while hemoglobin levels positively correlated with resting-state BOLD-CBF coupling in multiple brain areas. And resting-state BOLD-CBF coupling in the left hippocampus was linked to MoCA score. DKD patients exhibited more pronounced alterations in resting-state BOLD-CBF coupling compared to non-DKD patients, potentially linked to elevated blood glucose levels.

Diabetic peripheral neuropathy (DPN) provokes axonal degeneration and impairs nerve repair. Preclinical studies suggest that extracellular vesicles (EVs) exert neuroregenerative effects. As miRNAs are key, transferable bioactive cargoes that mediate the majority of observed EV functions in cell-to-cell communication, this systematic review specifically evaluated animal model evidence on the therapeutic potential of EV-derived miRNAs in alleviating DPN. A comprehensive search of MEDLINE, Embase, and ISI Web of Science was conducted on March 21, 2025 following PRISMA 2020 (PROSPERO registration ID: CRD420251130044). This review included studies that utilized in vivo models of DPN and in vitro hyperglycemic models only when corroborated by in vivo validation within the same study. Functional, electrophysiological, and histological assessments of nerve regeneration constituted the outcomes. Data were qualitatively synthesized and their quality was assessed using SYRCLE's Risk of Bias Tool. Nine studies met the inclusion criteria. The synthesis revealed a bidirectional regulatory role for EV miRNAs in DPN pathophysiology, dependent on both the miRNA species and the pathophysiological state of the EV source cell. Neuroprotective miRNAs (e.g., miR-21, -146a, let-7a, -20b-3p) from healthy or stem cell sources enhanced myelin integrity, nerve conduction, and neurovascularization, while mitigating neuroinflammation. Conversely, pathological hyperglycemia could reprogram EV cargo, leading to the enrichment of neurodegenerative miRNAs (e.g., miR-28, -31a, -221) that exacerbated neuropathic features. EV miRNAs exhibit significant improvement in peripheral nerve function, alleviating neuropathic pain, or promoting nerve regeneration under hyperglycemia. Nevertheless, preclinical research with more homogenous methods is necessary to advance clinical translation.

Diabetic foot ulcer (DFU) is a severe and debilitating complication of diabetes with limited effective therapeutic strategies, and persistent oxidative stress and inflammation are the core pathological factors leading to its impaired wound healing. RNA-binding protein UP frameshift 1 (UPF1) is implicated in modulating oxidative stress pathways, yet its regulatory role and underlying mechanism in DFU-associated oxidative stress remain largely unelucidated. This study aims to explore the function of UPF1 in oxidative stress during DFU pathogenesis and identify its related molecular regulatory axis, so as to provide novel therapeutic targets for DFU management. Human dermal fibroblasts (HDFs) were exposed to 30 mM high glucose (HG) to simulate diabetic conditions. The results showed that HG stimulation increased cytochrome P450 family 1 subfamily A member 1 (CYP1A1) and early growth response 1 (EGR1) expression, exacerbating oxidative stress and inflammation in HDFs. EGR1 knockdown or CYP1A1 inhibition attenuated these effects. Mechanistically, EGR1 transcriptionally activated CYP1A1, while UPF1 bound to and destabilized EGR1 mRNA. As expected, UPF1 upregulation rescued HG-induced inflammation and oxidative stress in HDFs, whereas concurrent EGR1 overexpression abolished this protective effect. In conclusion, UPF1 exerts a protective role in HG-stressed HDFs by degrading EGR1 mRNA, which in turn suppresses the transcriptional activation of CYP1A1 and subsequent CYP1A1-mediated oxidative stress and inflammation, thus uncovering a novel UPF1-EGR1-CYP1A1 regulatory axis in DFU pathogenesis. These core findings not only enrich the molecular understanding of oxidative stress regulation in DFU but also provide promising novel therapeutic targets for DFU management.

Diabetic kidney disease (DKD), a chronic microvascular complication is leading cause of End Stage Kidney disease (ESKD). Reduction of ≥30% urinary albumin is recommended to slow ESKD progression. Remote Ischemic conditioning (RIC) induces brief episodes of ischemia and reperfusion and has protective effect on various organs. The current study aims to explore the effects of RIC on albuminuria reduction in adults with type-2 Diabetes Mellitus.

In this double blind, sham controlled, Randomized Clinical Trial, we assigned 40 normotensive Diabetic adults with moderate and severely increased albuminuria to RIC group (n = 20) or Sham group (n = 20) weekly for 8 weeks. Primary outcome was reduction in albuminuria at the end of 8 weeks. Secondary outcomes were changes in serum creatinine, e-Glomerular Filtration Rate (eGFR), and HbA1c levels.

The reduction in albuminuria at the end of 8 weeks was 37.9% [Median (IQR): -7.5, 43.9] in the RIC group while it increased by 1.10% (-5.6, 15.2) in the Sham group (P = 0.015). Significant reduction was noted in serum creatinine in RIC group from 1 to 0.83 mg/dl as compared to increase in Sham group from 0.97 to 1.1 mg/dl (P = 0.0004). The mean eGFR in the RIC group improved from 85 to 99 (ml/min/1.73m2) P = 0.0001). No significant change was detected in HbA1C levels. Mild pain was the only adverse effect noted in 10% in the RIC group and none in the Sham group.

Among adults with DKD, treatment with RIC significantly reduced albuminuria and serum creatinine while improving the eGFR (CTRI/2024/09/074453).