Cushing's syndrome (CS) is associated with increased cardiovascular morbidity and mortality, both of which may persist after long-term remission. Our aim was to evaluate the prevalence of type 2 diabetes mellitus, fat distribution and other metabolic characteristics in patients with prior CS compared with matched population-based controls to assess metabolic risk factors.

Comorbidities were retrospectively analyzed in a cohort of 99 patients with CS from a single tertiary care center. Patients were longitudinally evaluated at baseline during active disease and at 7 years after biochemical remission. Data were compared to a control group matched for age and sex (n = 396) from the KORA study in a 1:4 fashion.

Despite long-term improvements, patients with CS in sustained remission still exhibit adverse metabolic outcomes 7 years after remission, including higher relative fat mass (39% vs. 35%, p = 0.0013), a higher waist-to-hip ratio (0.89 vs. 0.82, p < 0.0001), elevated HbA1c (5.5% vs. 5.4%, p = 0.0087), and increased diabetes prevalence (19% vs. 4%, p < 0.0001) compared with controls. These persistent metabolic alterations were strongly associated with inflammatory markers, suggesting inflammation as a potential contributor to the sustained diabetes risk.

Patients with prior CS remain burdened by adverse metabolic profiles that may contribute to their increased long-term cardiovascular risk.

Patients with chronic kidney disease and end-stage kidney disease (ESKD) are at increased risk of developing tuberculosis (TB). This study was to assess the proportion of positive interferon-gamma release assays (IGRAs) and its associated factors in latent and subclinical TB.

An observational study was conducted among asymptomatic adult patients with ESKD and hemodialysis. Positive PPD test or a previously documented positive PPD Active pulmonary or extrapulmonary tuberculosis patients were excluded. The clinical, laboratory, chest radiograph, and blood IGRAs assay were done at baseline and 6 months with additional sputum Xpert MTB/RIF, and cultures among the positive IGRAs.

159 participants were enrolled with the median age of 69 (IQR, 58-80). There were 82 male participants (51.6%).The most common comorbidities were hypertension, diabetes mellitus, and dyslipidemia. Of 159 participants, 28 (17.6%) had a positive IGRA test at baseline. Among the 26 surviving IGRA-positive participants at month 6, chest radiography revealed abnormalities in 22 (84·6%), with five (22·7%) showing findings specified as tuberculosis-related. Five participants (19·2%) developed symptoms related to tuberculosis during follow-up. Diabetes mellitus (odds ratio [OR] 2·54, 95% CI 1·04-6·18; p=0·00) and hypocalcemia (OR 3.93, 95% CI 1.56-9.90; p=0.004). were independently associated with IGRA positivity. Twelve participants died unrelated to TB. Baseline EQ-5D-5L utility scores and a visual analogue scale score below 60 and hypoalbuminemia were the strongest predictors of mortality.

IGRA is an important tool for screening test for TB in in ESKD patients with hemodialysis. High IGRA positivity with high confirmed TB at 6 months follow up was detected. Diabetes mellitus and hypocalcemia were independently associated with IGRA positivity.

Diabetes mellitus (DM) is a global public health crisis. Metabolic reprogramming alters cellular energy production and plays a key role in DM pathogenesis, yet a systematic overview of research trends, collaboration networks, and emerging frontiers in this field is lacking. This study performed a bibliometric analysis of 6,864 English-language articles and reviews published between 2016 and 2025, retrieved from Web of Science, PubMed, Scopus, and Embase. The analytical workflow included: (1) annual publication trend analysis, (2) country/region and institutional collaboration mapping, (3) author and journal co-authorship and co-citation analysis, (4) reference co-citation and burst detection, and (5) keyword and topic trend analysis, using three bibliometric analysis tools. Annual publications remained below 800 from 2016 to 2024 but exceeded 1,000 in 2025, indicating rapid growth. China contributed the largest share of papers (50%) and accounted for many of the top institutions, yet centrality analysis showed that the United States and European countries still lead in academic influence and knowledge generation. The knowledge structure is built on three core foundations: insulin resistance, oxidative stress, and mitochondrial function. Emerging research focuses on gut microbiota, machine learning, and metabolic reprogramming. Keyword bursts and topic trend maps reveal a paradigm shift from static phenotype observation to dynamic, multi-omics-integrated systems medicine. To our knowledge, no prior bibliometric study has specifically focused on the intersection of DM and metabolic reprogramming; this study thus provides the first dedicated mapping of this field. While China dominates in publication volume, centrality metrics indicate room for stronger international collaboration and academic leadership. Future efforts should promote interdisciplinary cooperation and support basic-to-clinical translation. This study provides an objective reference for research management and strategic planning.

The global rise in type 2 diabetes mellitus (T2DM) underscores the need to better understand its underlying biological mechanisms, particularly those involving host-microbiome interactions. This study aimed to characterize gut microbial diversity, taxonomic composition, and predicted metabolic pathways in newly diagnosed T2DM patients compared with the non-diabetic matched (NM) group. Fresh stool samples were analyzed using 16S rDNA sequencing. Alpha diversity (Chao, ACE, Shannon, and Simpson indices) and beta diversity were calculated to assess microbial community structure. Taxonomic differences were evaluated using Wilcoxon rank-sum tests and linear discriminant analysis effect size (LEfSe). Functional pathway prediction was performed using phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt2) based on KEGG and MetaCyc annotations. Mendelian randomization (MR) analysis, including inverse-variance weighting, MR-Egger, and weighted median methods, was applied to assess genetically predicted associations between microbial taxa and T2DM. Results showed reduced microbial richness, as reflected by lower Chao and ACE indices, and altered diversity structure, as reflected by lower Shannon and higher Simpson indices, in T2DM patients, accompanied by significant compositional shifts. Increased relative abundance of Proteobacteria and decreased abundance of beneficial taxa such as Lachnospiraceae and Blautia were observed. Functional prediction indicated reduced abundance of pathways related to the non-oxidative pentose phosphate pathway, isobutanol biosynthesis, and L-isoleucine biosynthesis. MR analysis provided complementary evidence supporting associations between specific microbial taxa and T2DM susceptibility. In conclusion, T2DM is associated with reduced microbial richness, altered diversity structure, and distinct taxonomic and functional changes. These findings highlight the relevance of gut microbiota in T2DM and support the potential utility of microbiome-based biomarkers and therapeutic strategies. Further studies are required to validate these findings and clarify underlying mechanisms.

We aimed to examine 25-yr trends in the incidence, age at diagnosis, seasonal variation, and frequency of diabetic ketoacidosis among children and adolescents with newly diagnosed type 1 diabetes mellitus in Serbia, before, during, and after the COVID-19 pandemic. This nationwide, multicentre, study included all individuals aged ≤ 19 yr diagnosed with T1DM between 2000 and 2024 across 15 paediatric centres in Serbia. Clinical characteristics were compared using parametric and non-parametric tests, as appropriate. A total of 4,335 new T1DM cases were registered. The incidence increased significantly from 9.7 per 100,000 in 2000 to 25.5 per 100,000 in 2021 (annual percent change (APC) 3.12%, p < 0.001). Among children aged 0-14 yr, incidence rose until 2016 (APC 4.14%, p = 0.01), followed by a plateau through 2024, suggesting possible stabilization in younger age groups. Monthly variations in the frequency of newly diagnosed T1DM cases did not reach statistical significance (p = 0.876). Overall, 42.4% of patients presented with DKA, with a marked rise during the COVID-19 pandemic (47.7%) and persistently higher post-pandemic levels compared with pre-pandemic years. Over 25 yr, Serbia experienced a steady increase in paediatric T1DM incidence with recent stabilization among younger children. DKA remains persistently high in post pandemic years.

Type 2 diabetes mellitus is a chronic disease that impacts health-related quality of life. Spiritual health may positively influence patients' well-being, being a relevant aspect for improving comprehensive management.

To assess the relationship between spiritual health and health-related quality of life in patients with type 2 diabetes mellitus, aiming to provide evidence to support interventions integrating medical and spiritual aspects.

A cross-sectional study conducted in 2024 with 230 patients from three hospitals. Spiritual health was measured using the ESE-UM scale, and health-related quality of life with the D-39 questionnaire. Spearman's correlation and non-parametric tests were used to analyze associations with sociodemographic (age, sex, socioeconomic status) and clinical factors (insulin use, disease progression).

A significant positive correlation was found between spiritual health and health-related quality of life (ρ=0.338, p<0.001). Women and patients with high socioeconomic status reported greater spiritual health, while younger adults and those not using insulin showed better health-related quality of life.

The findings confirm that spiritual health serves as a coping resource in type 2 diabetes mellitus, enhancing health-related quality of life, consistent with prior studies. Factors such as sex, socioeconomic status, and hospital setting influenced both variables.

Spiritual health significantly improves health-related quality of life in type 2 diabetes mellitus patients, influenced by sex, socioeconomic status, and hospital environment. Incorporating spiritual care into type 2 diabetes mellitus management could optimize clinical and well-being outcomes, considering these sociodemographic variables.

To examine the association between serum vitamin B12 levels and the prevalence of diabetic retinopathy (DR) among adults with type 2 diabetes mellitus (T2DM).

This study performed a secondary analysis of a cross-sectional dataset from the Department of Endocrinology, Guangdong Provincial People's Hospital (Dec 2017-Nov 2018). A total of 413 adults with T2DM were included, with DR adjudicated by board-certified ophthalmologists. Serum vitamin B12 was the exposure. Multivariable logistic regression assessed the vitamin B12 and DR association, alongside generalized additive models (GAMs) with smooth splines to explore nonlinearity. Prespecified subgroup and interaction analyses were conducted by sex, age, diabetes duration, blood pressure, lipid profile, and renal function.

After multivariable adjustment, each 100 μmol/L increase in vitamin B12 was significantly associated with a higher risk of DR (OR = 1.49, 95% CI: 1.12-1.99, p = 0.0067). Participants in the highest tertile of vitamin B12 (≥398 μmol/L) exhibited a substantially elevated risk of DR compared with those in the lowest tertile (OR = 11.83, 95% CI: 1.79-78.19, p = 0.0103). GAM indicated a linear positive association. No significant interactions were detected across prespecified subgroups (all P for interaction >0.05).

Higher serum vitamin B12 levels were independently and linearly associated with greater DR prevalence in adults with T2DM. However, temporal ordering and causality cannot be established.

Familial partial lipodystrophy (FPLD) is a rare genetic syndrome characterised by persistent, selective loss of adipose tissue and is closely associated with severe metabolic disturbances. Pregnancy in women with FPLD is associated with a high risk for both mother and foetus, while clinical experience remains very limited. Evidence from case reports and small series is essential for risk stratification, multidisciplinary management, and optimization of maternal and foetal health. Here, we report the case of a woman at 18 weeks of gestation with very severe hypertriglyceridaemia complicated by acute pancreatitis. The patient had a history of young-onset diabetes mellitus, hypertension, polycystic ovary syndrome (PCOS) and previously known hypertriglyceridaemia, accompanied by characteristic loss of gluteofemoral and lower limb adipose tissue, raising the clinical suspicion of FPLD. Molecular genetic analysis was performed using next-generation sequencing-based gene panel diagnostics. Variants were described according to Human Genome Variation Society (HGVS) nomenclature and classified according to the American College of Medical Genetics and genomics/Association for Molecular Pathology (ACMG/AMP) guidelines. We made the initial diagnosis of severe FPLD3 syndrome and detected a novel heterozygous c.380A>C, p.(Glu127Ala) variant in the peroxisome proliferator-activated receptor gamma gene (PPARG), classified as likely pathogenic and considered causative for the patient´s phenotype. In addition, a heterozygous variant of uncertain significance c.328G>A, p.(Ala110Thr) in the ATP-binding cassette transporter sub-family C member 8 gene (ABCC8), was detected. High-dose intensive insulin therapy in combination with metformin and omega-3 fatty acids resulted in a marked reduction in triglyceride levels, normalised blood glucose levels until delivery and avoided further episodes of pancreatitis. Early recognition of FPLD is crucial, particularly in high-risk settings such as pregnancy. Intensive, multidisciplinary metabolic management can stabilize severe metabolic complications and may enable favourable maternal and foetal outcomes.

Recurrence of diabetic foot ulcers (DFU) is a major clinical challenge, often leading to amputation. Temperature-guided preventive care based on skin temperature monitoring has been proposed as an early warning tool that can trigger preventive actions before overt ulceration develops. We conducted a systematic review and meta-analysis to evaluate its efficacy in preventing DFU recurrence in high-risk individuals.

We systematically searched PubMed, Embase, the Wiley Online Library, and Web of Science for randomized controlled trials comparing temperature-guided preventive care based on skin temperature monitoring with standard care. The primary outcome was time to first ulcer recurrence, with the hazard ratio (HR) as the effect measure. The secondary outcome was overall recurrence incidence, measured by the risk ratio (RR).

Six randomized controlled trials involving a total of 917 participants were included. The meta-analysis demonstrated a significant protective effect for temperature-guided preventive care. The intervention group had a significantly lower hazard of ulcer recurrence compared with the control group (HR 0.63; 95% CI: 0.49-0.82; p = 0.001). Similarly, the overall risk of recurrence was significantly reduced in the intervention group (RR 0.64; 95% CI: 0.52-0.80; p = 0.001).

Temperature-guided preventive care appears to be an effective, patient-driven intervention that may reduce the risk and incidence of DFU recurrence in high-risk individuals. These findings support the potential integration of this simple, proactive tool into standard preventive care protocols to mitigate the severe consequences of this complication.

Diabetic retinopathy (DR) continues to represent one of the principal etiologies of visual impairment among working-age populations, and the escalating global burden of diabetes mellitus suggests that this challenge will likely intensify in the coming decades. Conventional diagnostic modalities, most notably fluorescein angiography (FA), have long been employed as reference standards in clinical practice; nevertheless, these approaches are hampered by inherent drawbacks, including their invasive nature and the absence of depth-resolved structural information. The advent of optical coherence tomography angiography (OCTA) has provided a compelling non-invasive alternative capable of delivering depth-stratified vascular visualization. Subsequent technological refinements have yielded ultra-widefield (UWF) OCTA, which substantially extends the imaging field of view and affords detailed examination of the peripheral retinal vasculature that previously remained beyond the reach of conventional acquisition systems. The present review synthesizes current evidence regarding the clinical utility of UWF-OCTA in DR, with particular emphasis on its capacity to identify and characterize key retinal microvascular lesions, encompassing neovascularization (NV), non-perfusion areas (NPAs), microaneurysms (MAs), and intraretinal microvascular abnormalities (IRMAs). The vitreoretinal interface (VRI) slab for detecting NV, emerging choroidal metrics, and a comparison between UWF-OCTA and UWF-FA are also discussed. The evidence suggests that UWF-OCTA detects NV with high sensitivity and specificity, compares favorably to FA, and offers unique advantages, although limitations such as segmentation errors and a smaller field of view must be acknowledged. UWF-OCTA appears to be a promising non-invasive tool for DR diagnosis and monitoring, potentially complementing rather than completely replacing conventional angiography.