Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system with a complex etiology involving genetic and environmental factors. Maternal diabetes during pregnancy has been hypothesized to influence offspring MS risk through intrauterine metabolic programming, yet the evidence remains inconclusive.

To systematically review and meta-analyze the association between maternal diabetes and the risk of MS in offspring.

A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Embase, identifying 427 records. After removing 188 duplicates, 239 records were screened, 38 full-text reports were assessed for eligibility, and 4 studies met the inclusion criteria. Pooled risk ratios (RR) were calculated using both common-effect and random-effects models. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using Egger's and Begg's tests.

The studies, published between 2009 and 2026, were conducted in Denmark, the USA (two studies), and Norway, utilizing diverse designs including nationwide register-based cohorts and a case-control study. The common-effect model yielded a pooled RR of 1.42 (95% CI: 1.09-1.85), while the random-effects model produced a non-significant pooled RR of 3.13 (95% CI: 0.68-14.30). Substantial heterogeneity was observed across studies (I² = 95.2%, τ² = 2.2357, p < 0.0001). Individual study risk ratios ranged from 0.91 (95% CI: 0.60-1.38) to 28.35 (95% CI: 13.33-60.29). Neither Egger's test (p = 0.4364) nor Begg's test (p = 0.1742) indicated significant publication bias, though these tests have limited power with fewer than ten studies.

This meta-analysis did not demonstrate a statistically significant association between maternal diabetes and MS risk in offspring, likely owing to substantial between-study heterogeneity and the limited number of included studies. Large, well-characterized prospective cohorts are needed to clarify this relationship, elucidate underlying mechanisms, and inform preventive strategies.

Human brain tissues obtained from autopsies, as well as muscle and nerve samples derived from biopsies, constitute indispensable resources for translational research investigating the pathomechanisms of neuropsychiatric disorders. In this study, we introduce the Nervous System Tissue Bank of University of Debrecen, which contains formalin-preserved and formalin-fixed paraffin-embedded (FFPE) brain samples, as well as frozen nerve and muscle biopsy specimens. Database was established containing clinical and pathological parameters. For autopsy cases, the following variables were recorded: sex, age, number of hospitalization days, admission diagnosis, comorbidities, cause of death, post-mortem interval, general autopsy findings, and macro- and microscopic brain pathology diagnoses. For biopsy samples, we recorded: sex, age, biopsy site, and microscopic and molecular genetic diagnoses. Based on the recorded parameters and their temporal changes, retrospective statistical analyses were performed. Formalin-fixed brain samples and FFPE blocks were available from 2425 deceased individuals, and nerve/muscle samples from 257 patients. The brain samples originate from the period between 1990 and 2012. The most frequent admission diagnoses included ischemic stroke (n = 1070), hemorrhagic stroke (n = 462), subarachnoid hemorrhage (n = 102), epilepsy (n = 103), brain metastasis (n = 70), primary brain tumor (n = 60), parkinsonism (n = 28), dementia (n = 21), and amyotrophic lateral sclerosis (n = 21). Prevalence of hypertension (67.6%) and diabetes mellitus (20.1%) showed a significant increase over time (p < 0.001), whereas the prevalence of malignancies, dementia, parkinsonism, and psychiatric disorders remained stable. Our tissue bank represents the largest nervous system collection in Hungary, providing well-characterized brain, muscle, and nerve samples linked to nearly three decades of clinical data. Samples are made available to researchers.

Gestational diabetes mellitus (GDM) is increasingly common, with short- and long-term health risks. Building on the GooD4Mum pilot, which demonstrated quality improvements in general practice for care after GDM, this project implemented and evaluated a primary care Quality Improvement Collaborative (QIC) program to optimize identification, recall, screening, and referral of patients after GDM.

This study aimed to assess the effectiveness of QIC activities relative to usual practice for improving general practice clinicians' provision of follow-up and screening of patients with a history of GDM to ultimately support the onset of type 2 diabetes.

A 21-month, prospective non-randomized controlled trial (at practice level) was conducted, matching intervention practices 1:1 with controls. The QIC intervention is compared with care-as-usual in general practice to review implementation, effectiveness, and economic outcomes. For 18 months, the intervention practices engaged with the GooD4Mum QIC program, including education, training, resources, and Plan-Do-Study-Act (PDSA) cycles to implement locally relevant improvement activities. A clinical decision support system aided in the identification, screening, and tracking of patients with a history of GDM. Control practices provided care as usual. Primary outcomes are practice-level proportions of women with recorded type 2 diabetes screening, modifiable cardiometabolic risk factors, and referral to a diabetes prevention program. Secondary outcomes examine changes in care processes, adherence to clinical standards, and fidelity of intervention delivery. Outcome analyses use clinical data derived from practices via automated extraction. Baseline comparisons use t tests or chi-square tests. Primary and secondary outcomes are analyzed by repeated-measures ANOVA and/or cluster-adjusted generalized estimating equations, accounting for practice-level clustering, and sensitivity analyses include a per-protocol approach. Implementation outcomes are assessed through longitudinal qualitative interviews with practice leads, support staff, and stakeholders, guided by the CFIR (Consolidated Framework for Implementation Research) and the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework. Cost consequence analysis uses clinical activity and practice-reported data.

The program ran in 9 general practices between April 2024 and September 2025, with data collection until December 2025. Practice characteristics and protocol deviation are summarized. Detailed outcome, cost consequence, and implementation process evaluations will be reported elsewhere.

The protocol offers a novel quality improvement approach enhanced by clinical decision support and automated data extraction to optimize identification, screening, and provision of lifestyle advice toward reducing type 2 diabetes after GDM. The evaluation is designed to generate actionable insights and a scalable implementation toolkit to improve care after gestational diabetes.

Over half the global population lives in countries where obesity complications cause higher morbidity than underweight status. Obesity, a global epidemic, carries substantial health, social, and economic consequences. Class I obesity (body mass index [BMI] 30-35 kg/m²) is increasingly prevalent and associated with metabolic comorbidities including type 2 diabetes mellitus (DM) and hypertension (HTN). While bariatric surgery is established for severe obesity, its efficacy in class I obesity remains debated. This meta-analysis evaluated weight loss and comorbidity remission following bariatric surgery in class I obesity.

A systematic search of PubMed, Google Scholar, Cochrane Central, and ScienceDirect identified retrospective studies (2000-2024) reporting weight loss (%excess weight loss [EWL], %total weight loss, BMI) or comorbidity remission (DM, HTN) with ≥12-month follow-up in class I obesity patients undergoing bariatric surgery. Weight loss outcomes were restricted to sleeve gastrectomy (SG) for consistency. Pooled estimates and odds ratios (ORs) used random-effects models.

Nine retrospective studies (1,703 patients) met inclusion criteria. All had critical ROBINS-I bias risk. Following SG, pooled %EWL was 90.16% (95% CI, 71.21-109.11) at 12 months and 75.73% (95% CI, 74.66-76.80) at 24 months. Mean BMI fell to 24.70 kg/m² at 12 months and 25.66 kg/m² at 24 months. DM remission improved significantly (OR, 0.20; 95% CI, 0.07-0.57 at ≤2 years; OR, 0.15; 95% CI, 0.05-0.49 at >2 years). HTN remission was non-significant (OR, 0.80; 95% CI, 0.38-1.72 at ≤2 years; OR, 0.61; 95% CI, 0.22-1.64 at >2 years).

SG achieves substantial sustained weight loss in class I obesity with significant diabetes remission. However, critical bias limits evidence certainty. High-quality prospective trials are urgently needed.

PROSPERO Identifier: CRD420261296751.

Dipeptidyl peptidase-IV (DPP-IV) inhibition is a validated therapeutic mechanism for type 2 diabetes mellitus. Marine-derived bioactive peptides offer a diverse array of potential inhibitors but often exhibit pharmacokinetic limitations that impede clinical translation. This study aimed to identify and evaluate candidate peptides from Arbacia lixula as potential DPP-IV inhibitors using an integrated in silico approach. A total of twenty peptides were evaluated in silico for absorption, distribution, metabolism, excretion, and toxicity (ADMET) profiles using SwissADME, pkCSM, and ProTox. Molecular docking against DPP-IV was performed in MOE v2022.02 with linagliptin as the reference ligand; docking poses were evaluated by predicted binding energy and root mean square deviation (RMSD). Top-ranked peptide-DPP-IV complexes were subjected to 50 ns molecular dynamics (MD) simulations in YASARA Dynamics v4.3.13 to assess conformational stability. ADMET predictions showed low gastrointestinal absorption in most peptides, whereas Peptides 17, 18, and 20 showed high predicted absorption. No target-organ or endpoint-specific toxicity was predicted. Peptides 7, 15, and 18 were prioritized based on favorable docking scores, RMSD <2.0 Å, and relevant DPP-IV residue interactions. Docking scores were interpreted cautiously, not as direct quantitative comparisons with linagliptin. During 50 ns MD simulations, RMSD, root mean square fluctuation, radius of gyration, and solvent-accessible surface area profiles supported the stability, compactness, and dynamic consistency of selected peptide-DPP-IV complexes. Peptides 7, 15, and 18 showed favorable in silico predicting binding, relevant DPP-IV interactions, and acceptable preliminary safety profiles as potential DPP-IV inhibitory candidates. These findings should be interpreted as computational leads that require further in vitro and in vivo validation.

Substantial evidence demonstrates that diabetes is associated with periodontal disease. The purpose of this study was to analyze the scientometric characteristics and research trends of diabetes-associated periodontal disease (DAPD).

All the papers on DAPD were comprehensively retrieved from the Scopus database. The years of publication were divided into before 2019 and after 2019 in the analysis of research trends.

There were 2466 papers on DAPD, with total citations of 73,553 and the h index of 120. The trend of clinical investigations has highlighted periodontal examination, bone development, micro-computed tomography, tooth brushing, cardiovascular disease, hypertension, diabetic complication, diabetic periodontitis, drug therapy, fasting blood glucose level, gingival index, and questionnaire. The trend of laboratory investigations has changed to gene expression, macrophage, signal transduction, microbiota, microflora, RNA 16s, in vitro study, immune response, antioxidant, reactive oxygen metabolite, and interleukin (IL)-17 after 2019. There have always been common keywords such as tumor necrosis factor alpha, IL-1beta, IL-6, insulin resistance, C-reactive protein, osteolysis, Porphyromonas gingivalis, genetics, advanced glycation end-products, oxidative stress, and saliva.

This scientometric study elucidated the current scenario and research trends of DAPD, particularly the comprehensive identification and recognition of the important research topics concerned. A better understanding of diabetic-periodontal relationship supports interdisciplinary approaches and points toward novel preventive and therapeutic strategies.

Posterior circulation stroke (PCS) in the vertebrobasilar system carries high morbidity and mortality. While mechanical thrombectomy (MT) is effective in selected patients, functional recovery after MT for PCS remains variable and may be influenced by clinical, imaging and procedural factors.

To summarise clinical, imaging and procedural factors associated with functional recovery, defined as modified Rankin Scale 0-2 at 90 days, after MT in PCS.

This systematic review and meta-analysis searched EMBASE, MEDLINE, PubMed, EBSCO, Scopus, CNKI, SSRN, bioRxiv and medRxiv from inception until 31 December 2025. Inclusion criteria were adult patients with PCS who underwent MT in clinical trials or observational studies. Risk Of Bias In Non-randomised Studies-of-Exposure was assessed. Meta-analysis used a random-effects model to pool ORs with 95% CIs, assessing heterogeneity via I² and Cochran's Q test (PROSPERO: CRD42024626263).

We analysed 12 094 patients from 75 studies. Predictors of favourable outcomes included higher posterior circulation-Alberta Stroke Programme Early CT Score (OR=1.80, 95% CI 1.59 to 2.03, p<0.001, I²=0.0%), intravenous thrombolysis (OR=1.66, 95% CI 1.31 to 2.1, p<0.001, I²=21.7%), first-pass effect (OR=2.36, 95% CI 1.84 to 3.03, p<0.001, I²=9.28%) and modified thrombolysis in cerebral infarction 2b/3 (OR=3.58, 95% CI 2.31 to 5.55, p<0.001, I²=58.43%). Poor outcomes were associated with higher baseline National Institutes of Health Stroke Scale (OR=0.92, 95% CI 0.89 to 0.95, p<0.001, I²=85.09%), diabetes mellitus (OR=0.56, 95% CI 0.43 to 0.72, p<0.001, I²=24.63%), hypertension (OR=0.73, 95% CI 0.59 to 0.91, p=0.010, I²=0.0%) and general anaesthesia use (OR=0.56, 95% CI 0.36 to 0.89, p=0.010, I²=64.53%).

Stroke severity, imaging scores and procedural success are factors consistently reported to be associated with functional outcomes in PCS after MT. Although the independence of these factors cannot be determined from this analysis, these findings may help summarise current evidence on reported prognostic factors and support future prospective validation using standardised protocols.

Diabetes mellitus and its complications are chronic inflammatory diseases driven by metabolic stress. PANoptosis is a recently defined inflammatory lytic cell death pathway that integrates key features of pyroptosis, apoptosis, and necroptosis, and is orchestrated by the PANoptosome complex. Emerging evidence indicates that PANoptosis plays a critical role in the pathogenesis of diabetic complications, prominently in diabetic kidney disease, retinopathy, neuropathy, and cardiomyopathy, with emerging indirect evidence from surrogate models suggesting its potential involvement in diabetic foot ulcers. In this review, we summarise the core molecular mechanisms of PANoptosis, with a focus on the crosstalk among the three programmed cell death pathways under diabetic conditions. We discuss how metabolic stressors such as hyperglycaemia, lipotoxicity, and endoplasmic reticulum stress activate distinct PANoptosome assemblies-including those involving Z-DNA-binding protein 1 (ZBP1), absent in melanoma 2 (AIM2), receptor-interacting protein kinase 1 (RIPK1), NOD-like receptor family pyrin domain-containing protein 12 (NLRP12), NOD-like receptor family pyrin domain-containing protein 3 (NLRP3), and NOD-like receptor family CARD domain-containing protein 5 (NLRC5)-thereby linking metabolic dysregulation to inflammatory cell death. Moreover, we highlight recent advances in targeting PANoptosis as a therapeutic strategy, emphasising interventions directed at upstream metabolic triggers, PANoptosome components, and downstream effector molecules. Finally, we identify key knowledge gaps and propose future research directions to facilitate clinical translation. A deeper understanding of PANoptosis in diabetic complications may pave the way for novel therapeutic approaches that simultaneously block multiple cell death pathways to ameliorate disease progression.

Diabetes mellitus is a global metabolic disorder characterized by progressive pancreatic β-cell failure, which leads to inadequate insulin secretion, often in combination with insulin resistance, and ultimately disrupts glucose homeostasis. The Integrated Stress Response (ISR), a crucial signaling network that enables cells to maintain homeostasis under endogenous and exogenous pressures, has garnered increasing attention for its role in regulating islet β-cell function and contributing to their failure. In recent years, a growing body of evidence has revealed that the ISR acts as a dual-edged sword in the onset and progression of diabetes. On the one hand, ISR activation can transiently relieve biosynthetic stress and help preserve cellular homeostasis. On the other hand, persistent or dysregulated ISR signaling is increasingly associated with impaired insulin production, loss of β-cell identity, and cell death in diabetes. In this Review, we summarize the molecular architecture of the ISR, focus on its regulatory role in pancreatic β-cell stress biology, and examine how ISR-related pathways are engaged in monogenic diabetes, type 1 diabetes, and type 2 diabetes. We further evaluate current therapeutic strategies targeting ISR-associated pathways and highlight the central translational challenge in this field, aiming to provide a theoretical basis and novel insights for a deeper understanding of the molecular mechanisms driving diabetic β-cell failure and for the development of novel precision therapeutic approaches.

Rhino-orbito-facial mucormycosis is a rapidly progressive, life-threatening fungal infection that predominantly affects patients with uncontrolled diabetes mellitus, particularly those with diabetic ketoacidosis (DKA). Early diagnosis remains challenging in resource-limited settings because initial manifestations often mimic bacterial sinusitis.

We report a 38-year-old woman with newly diagnosed diabetes mellitus presenting with left facial pain, swelling, and nasal discharge accompanied by mild DKA. She was initially treated for bacterial maxillary sinusitis with antibiotics and insulin therapy; however, progressive facial necrosis and subsequent orbital involvement prompted surgical debridement and histopathological examination, which confirmed mucormycosis. The patient underwent repeated surgical debridement, conventional amphotericin B therapy, and intensive glycemic control, resulting in complete clinical recovery without recurrence during 3 years of follow-up.

This case highlights the diagnostic challenges of mucormycosis in resource-limited settings and emphasizes the importance of maintaining a high index of suspicion in diabetic patients whose facial or orbital symptoms worsen despite appropriate antibacterial therapy. Early histopathological confirmation, prompt antifungal treatment, and multidisciplinary management remain essential for improving outcomes, even when advanced diagnostic resources are limited.