Highlights

• Three estimated glomerular filtration rate (eGFR) trajectories were identified among Asian individuals with type 2 diabetes: stable initially then gradual decline (75%), progressive decline (21.9%), and rapid decline (3.1%)
• Multiple factors were associated with progressive or rapid eGFR decline (eg, women, low socioeconomic status, high hemoglobin A_1c, and albuminuria)
• Progressive and rapid eGFR decline were associated with a higher risk of end-stage kidney disease (ESKD)
• Our results highlight the gender and social disparities in renal function decline and also underscore the potential benefit of multifactorial intervention targeting the modifiable risk factors to postpone ESKD.

Highlights

• Nuclear factor erythroid 2-related factor 2 (NRF2) is an oxidant stress response transcription factor, and is involved in metabolism, inflammation, autophagy, proteostasis, mitochondrial physiology, and immune responses.
• Chronic hyperglycemia in diabetes and prediabetes conditions induces a decrease in NRF2 that leads to an increase of oxidative stress and inflammation.
• NRF2 links neuroinflammation and apoptotic pathways and contributes to the development of diabetic neuropathy.

Highlights

• We defined a fasting-based disposition index (structure parameter inference approach-disposition index [SPINA-DI]), calculated as the product of the secretory capacity of pancreatic beta cells (SPINA-GBeta) multiplied by estimated insulin receptor gain (SPINA-GR).
• SPINA-DI mirrors the recognized hyperbolic relationship between beta-cell function and insulin sensitivity.
• It significantly correlates with the dynamic disposition index based on frequently sampled oral glucose tolerance tests (Matsuda–DeFronzo method) and other important measures of insulin-glucose homeostasis.
• For the diagnosis of diabetes and prediabetes, it has a higher discriminatory power than other static function tests (homeostatic model assessment of β-cell function, homeostatic model assessment of insulin resistance, and quantitative insulin sensitivity check index) and dynamic, oral glucose tolerance testing-derived parameters (insulin sensitivity index, insulinogenic index and disposition index according to Matsuda and DeFronzo).
• SPINA-DI has high retest reliability compared to other markers of glucose homeostasis.
• This novel fasting-based disposition index (SPINA-DI) is defined as the product of insulin receptor gain (SPINA-GR) multiplied by beta-cell function (SPINA-GBeta). SPINA-DI may be reduced due to insulin resistance with insufficient dynamical compensation of beta-cell mass (red horizontal arrow) or due to primary beta-cell failure (red vertical arrow). SPINA-DI was validated in three cohorts. It had advantages in validity, reliability, and diagnostic power compared to established criteria.

Highlights

• Elevated GA levels in serum were associated with stroke adverse outcomes.
• Adding GA into the conventional model resulted in slight improvements in predicting poor functional outcomes.
• The association between GA and poor functional outcomes was more pronounced in nondiabetic patients.

Highlights

• A clear association was observed between FBG levels and the risk of all-cause mortality in PD patients, indicating that FBG is a significant indicator for quantifying the risk of all-cause mortality in these patients.
• Although a higher FBG level was significantly associated with an increased risk of cardiovascular-related death, there was no notable increase in the risk of death from cancer or infections as the FBG levels increased.

Highlights

• Diabetic patients more often has comorbidities such as ischemic heart disease, hypertension, dyslipidemia, or renal impairment, higher uric acid, lower hemoglobin, and lower eGFR.
• Based on a large prospective multicenter registry, we found that the combination of diabetes and NT-proBNP levels may help stratify the prognosis of patients with chronic heart failure when the NT-proBNP level is low.
• High NT-proBNP is in itself a strong predictor of events (all-cause death, left ventricle assist device implantation, and orthotopic heart transplantation), that the addition of diabetes mellitus will no longer improve the stratification of patient prognosis in this group.

Highlights

• Maturity-onset diabetes of the young type 6 (MODY6) is a rare form of monogenic diabetes mellitus due to NEUROD1 gene mutation on chromosome 2q32.
• A 21-year-old woman exhibiting weight loss, polyuria, and hyperglycemia was initially misdiagnosed with type 1 diabetes mellitus.
• Considering the early-onset age, a three-generation family history of diabetes, and negative autoimmune antibodies, a MODY diagnosis was suspected.
• Genetic analysis revealed that she inherited a novel heterozygous nonsense NEUROD1 mutation c.747C>G (p.Tyr249*) from her father.
• Correct MODY6 diagnosis facilitates appropriate interventions.

Highlights

• Resveratrol improves renal function in diabetic nephropathy at low and high doses.
• It targets oxidative stress, inflammation, and metabolic regulation for renoprotection.
• Further research is needed for clinical translation and optimal dosing strategies.

Highlights

• T2DM dominates worldwide, especially in the low middle income countries (LMICs) of South Asia.
• Despite acknowledging self-management as the corner stone in T2DM, LMICs face an implementation gap due to lacking policies and the fragmented care systems, neglecting crucial personal, behavioral, and social factors.
• In this first large-scale multicenter randomized controlled trial conducted in Pakistan, a LMIC, the nurse-led PACE-SMI demonstrated significant improvement in HbA1c, self-efficacy, and self-care behaviors in adults with T2DM at 3 months.
• Considering the substantial health and economic impact of T2DM in LMICs, evidence presented in this study holds implications for the healthcare policies, advocating for integration of PACE-SMI into standard practice.