1,721,106 research outputs found
Perturbation of Glucose Homeostasis During Acute Illness: Stress Hyperglycemia and Relative Hypoglycemia
No full textDo epigenetic echoes of gestational diabetes craft a transgenerational path to cardio-metabolic disease?
No full textSGLT-2 Inhibitors and Circulating Progenitor Cells in Diabetes
No full textHess et al. recently hypothesized that shifts in circulating progenitor cell populations may drive cardiovascular protection by SGLT-2 inhibitors in patients with type 2 diabetes. In this Letter, Fadini challenges that interpretation and discusses previous findings from an independent randomized placebo-controlled trial indicating that cardiovascular protection by SGLT-2 inhibitors may not directly involve circulating stem/progenitor cells
Vitamin D and Cardiovascular Risk: Stemming the Tide of Poor Outcomes in Coronary Heart Disease
No full textReal-world Evidence on Oral Semaglutide for the Management of Type 2 Diabetes. A Narrative Review for Clinical Practice
Full text linkPurpose: Oral semaglutide is the first oral glucagon-like peptide-1 receptor agonist (GLP-1RA) available for type 2 diabetes mellitus (T2DM) management, whose effectiveness and tolerability have extensively been demonstrated in the PIONEER clinical trial program. Nevertheless, data from real-world are crucial to evaluate treatment performance under routine care. The aim of this narrative review is to summarize available evidence regarding real-world utilization patterns of oral semaglutide, and discuss efficacy, safety, and dosing regimen data in routine scenarios. Methods: We searched PubMed for real-world studies evaluating oral semaglutide up to August 2024, and specific search terms were: “oral semaglutide,” and “real-world studies” or “observational studies” or “retrospective studies”. Findings: 19 real-world studies were included in the narrative review. In real-world settings, oral semaglutide provided significant glycemic (median HbA1c reduction at 6 months of 1%) and weight (median body weight reduction of 2 to 3 kg) benefits across the spectrum of T2DM, aligning with pre-clinical evidence from the PIONEER program. No new tolerability and safety issue has emerged from oral semaglutide administration in routine clinical practice. Implications: Oral semaglutide constitutes an effective and safe option for T2DM management, and its increased acceptance has the potential to favor the early introduction of GLP-1RAs along the disease course. Nevertheless, continuous evaluation of real-world data is critical to better define the optimal positioning of oral semaglutide along T2DM trajectory and fully exploit its potential in everyday clinical practice
Cardiovascular and heart failure outcomes with type 2 diabetes therapies: how important is weight loss?
No full textManaging diabetes in diabetic patients with COVID: where do we start from?
Full text linkAims: COVID-19 has and still is sweeping away the national health systems worldwide. In this review, we sought to determine the evidence base proofs on the antidiabetic treatment capable to reduce the risk of COVID-19-related mortality. Methods: We have performed a systematic search of published articles using PubMed, and EMBASE from March 2020 to March 31st, 2021. We excluded editorials, commentary, letters to the editor, reviews, and studies that did not have mortality as an outcome. For metformin and insulin only, we performed a meta-analysis using Cochrane RevMan 5.2. Results: Among antidiabetic drugs, metformin was the only drug associated with a reduced risk of mortality. Conversely, insulin appears associated with an increased risk. The other classes of drugs were neutral. Conclusions: The totality of articles reports retrospective data strongly affected by “channeling bias” so that most of the existing results on each class of drugs are driven by the phenotype of patients likely to receive that specific drug by prescription
Concise Review: Perspectives and Clinical Implications of Bone Marrow and Circulating Stem Cell Defects in Diabetes
No full textDiabetes mellitus is a complex systemic disease characterized by severe morbidity and excess mortality. The burden of its multiorgan complications relies on an imbalance between hyperglycemic cell damage and defective endogenous reparative mechanisms. Inflammation and abnormalities in several hematopoietic components are typically found in diabetes. The discovery that diabetes reduces circulating stem/progenitor cells and impairs their function has opened an entire new field of study where diabetology comes into contact with hematology and regenerative medicine. It is being progressively recognized that such rare circulating cell populations mirror finely regulated processes involved in hematopoiesis, immunosurveillance, and peripheral tissue homeostasis. From a clinical perspective, pauperization of circulating stem cells predicts adverse outcomes and death. Furthermore, studies in murine models and humans have identified the bone marrow (BM) as a previously neglected site of diabetic end-organ damage, characterized by microangiopathy, neuropathy, fat deposition, and inflammation. As a result, diabetes impairs the mobilization of BM stem/progenitor cells, a defect known as mobilopathy or myelokathexis, with negative consequences for physiologic hematopoiesis, immune regulation, and tissue regeneration. A better understanding of the molecular and cellular processes that govern the BM stem cell niche, cell mobilization, and kinetics in peripheral tissues may uncover new therapeutic strategies for patients with diabetes. This concise review summarizes the current knowledge on the interplay between the BM, circulating stem cells, and diabetes, and sets the stages for future developments in the field. Stem Cells 2017;35:106–116
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