Pathological changes in the cellular structures of retina and choroidea in the early stages of alloxan-induced diabetes

AIM To investigate the temporal sequence of pathological changes in the cellular structures of retina and choroidea in the early stages of diabetes in laboratory animals.METHODS Experimental type 1 diabetes was modeled by three intraperitoneal injections of an alloxan solution into 30 male nonlinear rats at 16 wk of age. The 30 th and 60 th days from the final alloxan injection were chosen as the endpoints. Light and electron microscopy and morphometric and immunohistochemical studies were performed on histological slices of eyeballs from experimental animals.RESULTS Diabetic disturbances progressed to 60 d of the experiment. Thus, in the retina, a partial destruction of photoreceptors accompanied by interstitial edema was observed. The morphometric analysis revealed a reduction in the thickness of the retina. A reduction in the number of blood vessels of the choroid with disturbances of the endothelial cells and the vascular walls and a persistent reduction in the number of melanocytes were observed. The number of proliferating Ki-67 positive cells decreased, and the number of macrophages increased with diabetes development.CONCLUSION The starting point in the development of destructive changes involves early reduction in the number of melanocytes of the choroidea and alterations in the retinal pigment epithelium.

Evaluation of protective effect of cactus pear seed oil(Opuntia ficusincida L. MILL.) against alloxan-induced diabetes in mice

Objective: To evaluate the in vitro antioxidant power of cactus pear seed oil [Opuntia ficusincida L. MILL.(CPSO)] and its protective effect against chemically induced diabetes mellitus in mice. Methods: The in vitro antioxidant effect of CPSO was evaluated using 2,2-diphenyl-1-picrylhydrazyl(DPPH) scavenging assay. The preventive effect was conducted on Swiss albino mice treated with CPSO(2 m L/kg, per os), before and after a single intraperitoneal alloxan administration(100 mg/kg). Survival rate, body weight and fasting blood glucose were measured and histopathological analysis of pancreas was performed to evaluate alloxaninduced tissue injuries. Results: CPSO exhibited an antioxidant effect in DPPH scavenging assay. Moreover, the administration of CPSO(2 m L/kg) significantly attenuated alloxaninduced death and hyperglycemia(P<0.001) in treated mice. Morphometric study of pancreas revealed that CPSO significantly protected islets of langerhans against alloxan induced-tissue alterations. Conclusions: Based on theses results, CPSO can prevent alloxan-induced-diabetes by quenching free radicals produced by alloxan and inhibiting tissue injuries in pancreatic β-cells.

Hydro-Ethanol Extract of Persea americana Fruit Pulp Ameliorates Dyslipidaemia and Cardiotoxicity Exerted by Alloxan-Induced Diabetes Mellitus

Diabetes-induced dyslipidaemia has been associated with an increased risk of atherosclerosis and coronary heart diseases. Persea americana fruit has been reported to possess anti-diabetic properties. Therefore, this study assessed the lipid profile and likely cardio-protective effects of hydroethanolic extracts of P. americana fruits in alloxan-induced diabetic Wistar rats. Thirty-five male rats (150 ± 30 g) were divided into 5 groups (n = 7) and treated orally as follows;groups I-II were normal animals treated with distilled water (0.3 ml/day) and P. americana (300 mg/kg) only respectively. Animals in groups III-V were made diabetic using alloxan monohydrate (100 mg/kg i.p.) and treated orally with distilled water (0.3 ml/day), P. americana (300 mg/kg) and glibenclamide (5 mg/kg) respectively for 21 days. Fasting blood glucose level was monitored prior to, after induction of diabetes mellitus, and on day 21 post-treatment, respectively. Thereafter, retro-orbital blood samples were collected after anaesthesia and analysed for insulin, total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) levels, apolipoproteins A1 and B, superoxide dismutase (SOD) and catalase activities, reduced glutathione (GSH), Vitamin C and malondialdehyde levels, respectively. VLDL, atherogenic index (AI) and ApoB/A1 ratio were estimated mathematically. Pancreatic and cardiac structures were also investigated using Haematoxylin and Eosin stains. Treatment with P. ameriacana extracts reduced (p P. americana treated diabetic group. The hydro-ethanol fruit extract of Persea americana attenuates diabetes induced dyslipidaemia and reduces the susceptibility to cardiac impairment in experimental diabetes mellitus.

Tylophora hirsuta L. leaf extract attenuates alloxan-induced diabetes in mice by suppressing oxidative stress and α-amylase

Objective:To evaluate the antidiabetic potential of leaf extracts of Tylophora hirsuta(T.hirsuta).Methods:The methanolic and ethyl acetate extracts of T.hirsuta leaves were analyzed by high pressure liquid chromatography.In vitro antioxidant activity was determined by ferric ion reduction,1,1-diphenyl-2-picrylhydrazyl,and hydrogen peroxide scavenging methods.In vitro alpha amylase(α-amylase)inhibitory activity of the plant extracts was assessed.In vivo antidiabetic potential was determined in alloxan-induced diabetic mice to assess glycated hemoglobin(HbA1c),oral glucose tolerance,serum amylase,lipid profile,fasting blood glucose,and body weight.Histopathological lesions of the pancreas,liver and kidney were observed.Oxidative stress biomarkers such as superoxide dismutase,catalase and peroxidase were also determined.Results:Quercetin,chlorogenic acid,p-coumaric acid,and m-coumaric acid were found in the plant extracts.The methanolic plant extract exhibited higher in vitro antioxidant activities than the ethyl acetate extract.Moreover,methanolic plant extract exhibited(83.90±1.56)%α-amylase inhibitory activity at 3.2 mg/mL concentration.Animal study showed that the methanolic extract of T.hirsuta improved the levels of fasting blood glucose,HbA1c,serumα-amylase,lipid profile,liver function biomarkers,and kidney functions of diabetic mice.Moreover,the methanolic extract ameliorated diabetes-related oxidative stress by increasing superoxide dismutase and catalase activities and decreasing peroxidase and malondialdehyde levels.Histopathological examination showed that the plant extract had improved the integrity of pancreatic islets of Langerhans and reduced the pathological lesions in the liver and kidney of diabetic mice.Conclusions:The methanolic extract of T.hirsuta exhibits pronounced antidiabetic activity in mice through reduction of oxidative stress.The plant extract has several natural antioxidants such as phenolic acids.T.hirsuta extract could serve as a nutraceutical for managing diabetes mellitus.

Poorly controlled type Ⅱ diabetes mellitus significantly enhances postoperative chemoresistance in patients with stage Ⅲ colon cancer

BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and long-term disease-free survival(DFS)and overall survival(OS)in patients with stage Ⅲ CC who receive curative resection remain controversial.AIM To investigate whether T2DM or glycemic control is associated with worse postoperative survival outcomes in stage Ⅲ CC.METHODS This retrospective cohort study included 278 patients aged 40-75 years who underwent surgery for stage Ⅲ CC from 2018 to 2021.Based on preoperative T2DM history,the patients were categorized into non-DM(n=160)and DM groups(n=118).The latter was further divided into well-controlled(n=73)and poorly controlled(n=45)groups depending on the status of glycemic control.DFS,OS,and CRR were compared between the groups and Cox regression analysis was used to identify risk factors.RESULTS Patients in the DM and non-DM groups demonstrated similar DFS,OS,and CRR(DFS:72.03%vs 78.75%,P=0.178;OS:81.36%vs 83.12%,P=0.638;CRR:14.41%vs 7.5%,P=0.063).Poorly controlled DM was associated with a significantly worse prognosis and higher CRR than well-controlled DM(DFS:62.22%vs 78.07%,P=0.021;OS:71.11%vs 87.67%,P=0.011;CRR:24.40%vs 8.22%,P=0.015).High preoperative fasting plasma glucose[DFS:Hazard ratio(HR)=2.684,P<0.001;OS:HR=2.105,P=0.019;CRR:HR=2.214,P=0.005]and glycosylated hemoglobin levels(DFS:HR=2.344,P=0.006;OS:HR=2.119,P=0.021;CRR:HR=2.449,P=0.009)indicated significantly poor prognosis and high CRR,while T2DM history did not(DFS:HR=1.178,P=0.327;OS:HR=0.933,P=0.739;CRR:HR=0.997,P=0.581).CONCLUSION Increased preoperative fasting plasma glucose and glycosylated hemoglobin levels,but not T2DM history,were identified as risk factors associated with poor postoperative outcomes and high CRR in patients with stage Ⅲ CC.

Association of the glycemic background patterns and the diabetes management efficacy in poorly controlled type 2 diabetes

BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic control.METHODS This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 months.Participants were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as needed.The analysis focused on the success rates of good glycemic control and the associated factors within each group.RESULTS The study showed significant improvements in HbA1c levels in all participants.The most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,respectively.After one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and below.CONCLUSION In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored strategies.Therefore,different and comprehensive treatment approaches are needed for patients with persistent uncontrolled diabetes.

Importance of etiologies of secondary diabetes:How often do we think off in clinical practice?

The article"Secondary diabetes due to different etiologies:Four case reports"by Song et al,published in the World Journal of Clinical Cases,delves into the identi-fication of rare causes of secondary diabetes and emphasizes the necessity for healthcare professionals to recognize these conditions.Failure to do so can result in treatment delays and compromised patient outcomes.The article discusses spe-cific types of diabetes,including maturity onset of diabetes in young,pancreas-related diseases,endocrinopathies,drug-induced diabetes,infections,and con-genital genetic syndromes associated with diabetes mellitus.Case summaries highlight how patients with secondary diabetes,stemming from conditions such as Williams-Beuren syndrome and pituitary adenoma,often exhibit distinct characteristics overlooked in clinical practice.The authors stress the importance of a holistic diagnostic approach and advocate for proactive management through early intervention,including genetic tests and antibody detection.Increased awa-reness and education are crucial for timely identification and proper management,ultimately improving patient well-being.These findings prompt a call to action for healthcare professionals to consider rare causes of secondary diabetes,facili-tating better glycemic control and overall patient care.

Role of nutrition in diabetes mellitus and infections

In this editorial,we have commented on the article that has been published in the recent issue of World Journal of Clinical Cases.The authors have described a case of unilateral thyroid cyst and have opined that the acute onset of infection may be linked to diabetes mellitus(DM).We have focused on the role of nutrition in the association between DM and infection.Patients with DM are at a high risk of infection,which could also be attributed to nutrition-related factors.Nutritional interventions for patients with diabetes are mainly based on a low-calorie diet,which can be achieved by adhering to a low-carbohydrate diet.However,dietary fiber supplementation is recommended to maintain the diversity of the gut microbiota.Furthermore,high-quality protein can prevent the increased risk of infection due to malnutrition.Supplementation of vitamins C,vitamins A,vitamins D,and folic acid improves blood sugar control and facilitates immune regulation.Mineral deficiencies augment the risk of infection,but the relationship with diabetes is mostly U-shaped and a good intake should be maintained.

Enhancing metformin efficacy with cholecalciferol and taurine in diabetes therapy:Potential and limitations

Diabetes mellitus,particularly type 2 diabetes mellitus(T2DM),poses a significant global health challenge.Traditional management strategies primarily focus on glycemic control;however,there is a growing need for comprehensive approaches addressing the complex pathophysiology of diabetes complications.The recent study by Attia et al explores the potential of a novel therapy combining metformin with cholecalciferol(vitamin D3)and taurine to mitigate T2DM-related complications in a rat model.The findings indicate that this treatment combination improves glycemic control and reduces oxidative stress,inflammation,and lipid abnormalities.However,the study is limited by a lack of safety profile data and in-depth molecular mechanism insights.This editorial critically highlights the study's strengths and weaknesses,compares it against other combination therapy research in T2DM,and underscores the need to explore further the mechanisms underpinning the observed therapeutic effects and investigate the safety profile of this novel approach.

Ubiquitination in diabetes and its complications:A perspective from bibliometrics

BACKGROUND Diabetes has a substantial impact on public health,highlighting the need for novel treatments.Ubiquitination,an intracellular protein modification process,is emerging as a promising strategy for regulating pathological mechanisms.We hypothesize that ubiquitination plays a critical role in the development and progression of diabetes and its complications,and that understanding these mechanisms can lead to new therapeutic approaches.AIM To uncover the research trends and advances in diabetes ubiquitination and its complications,we conducted a bibliometric analysis.METHODS Studies on ubiquitination in diabetes mellitus and its complications were retrieved from the Web of Science Core Collection.Visual mapping analysis was conducted using the CiteSpace software.RESULTS We gathered 791 articles published over the past 23 years,focusing on ubiquitination in diabetes and its associated complications.These articles originated from 54 countries and 386 institutions,with China as the leading contributor.Shanghai Jiao Tong University has the highest number of publications in this field.The most prominent authors contributing to this research area include Wei-Hua Zhang,with Zhang Y being the most frequently cited author.Additionally,The Journal of Biological Chemistry is noted as the most cited in this field.The predominant keywords included expression,activation,oxidative stress,phosphorylation,ubiquitination,degradation,and insulin resistance.CONCLUSION The role of ubiquitination in diabetes and its complications,such as diabetic nephropathy and cardiomyopathy,is a key research focus.However,these areas require further investigations.

New exploration on pathogenesis and early diagnosis of gestational diabetes

Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards.Although GDM patients constitute a small proportion of the total number of diabetes cases,the incidence of GDM has risen significantly over the past decade,posing substantial risk to pregnant women and infants.Therefore,it warrants considerable attention.The pathogenesis of GDM is generally considered to resemble that of type II diabetes,though it may have distinct characteristics.Analyzing blood biochemical proteins in the context of GDM can help elucidate its pathogenesis,thereby facilitating more effective prevention and management strategies.This article reviews this critical clinical issue to enhance the medical community's sufficient understanding of GDM.

Microplastic and nanoplastic exposure and risk of diabetes mellitus

The issue of plastic pollutants has become a growing concern.Both microplastics(MPs)(particle size<5 mm)and nanoplastics(NPs)(particle size<1μm)can cause DNA damage,cytotoxicity,and oxidative stress in various organisms.The primary known impacts of microplastic/nanoplastic are observed in the liver and respiratory system,leading to hepatotoxicity and chronic obstructive pulmonary disease.Although research on the effects of MPs and NPs on diabetes is still in its early stages,there are potential concerns.This editorial highlights the risk to diabetics from co-exposure to contaminants and MPs/NPs,supported by evidence from animal studies and the various chemical compositions of MPs/NPs.

Mizagliflozin ameliorates diabetes induced kidney injury by inhibitor inhibit inflammation and oxidative stress

BACKGROUND Mizagliflozin(MIZ)is a specific inhibitor of sodium-glucose cotransport protein 1(SGLT1)originally developed as a medication for diabetes.AIM To explore the impact of MIZ on diabetic nephropathy(DN).METHODS Diabetic mice were created using db/db mice.They were administered either a low dose(0.5 mg/kg)or a high dose(1.0 mg/kg)of the SGLT1 inhibitor MIZ via stomach gavage for 8 weeks.Subsequently,mesangial cells(MCs)were isolated and subjected to high glucose conditions in culture to assess the effects of MIZ on DN.RESULTS The results showed that low doses of MIZ significantly reduced albuminuria to a level comparable to that achieved with high doses in db/db mice.High doses of MIZ led to a substantial increase in body weight in mice,along with decreased blood glucose levels and food intake.Moreover,the intervention with high-dose MIZ notably decreased the expression of extracellular matrix genes,such as collagen type 1 alpha 1 mRNA levels.While the expression of SGLT1 increased after exposure to high glucose,it decreased following treatment with MIZ.Furthermore,MIZ intervention was more effective in improving lactate dehydrogenase levels in MCs induced by high glucose compared to canagliflozin.MIZ also significantly elevated levels of antioxidant enzymes superoxide dismutase,catalase,and glutathione,while reducing malondialdehyde levels.CONCLUSION These findings indicate that MIZ can ameliorate DN by inhibiting SGLT1,inflammation,and oxidative stress.

Global trends and hotspots of type 2 diabetes in children and adolescents:A bibliometric study and visualization analysis

BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.

Association between age at diagnosis of diabetes and ocular disease:Insights from a recent article

In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,highlighted a strong link between early diabetes onset and major eye conditions,such as cataracts,glaucoma,agerelated macular degeneration,and vision loss,independent of glycemic control and disease duration.This finding challenges the previous belief that diabetic eye disease primarily correlates with hyperglycemia.As lifestyles evolve and the age of diabetes diagnosis decreases,understanding this relationship may reveal the complex pathogenesis underlying diabetes-related complications.This editorial summarizes potential mechanisms connecting the age of diabetes onset with four types of ocular diseases,emphasizing the significance of early diagnosis.

Intestinal glucagon-like peptide-1:A new regulator of impaired counterregulatory responses to hypoglycemia in type 1 diabetes mellitus

In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With the global rise of T1DM,there is an increased burden on society and healthcare systems.Due to insulin therapy and islet dysfunction,T1DM patients are highly vulnerable to severe hypoglycemia,a leading cause of mortality.In healthy individuals,counterregulatory mechanisms restore blood glucose during hypoglycemia,but repeated episodes impair these responses.Jin et al demonstrated that overexpression of GLP-1 attenuates the sympathetic-adrenal reflex and disrupts the secretion of counterregulatory hormones such as glucagon during hypoglycemia,leading to counterregulatory dysfunction.These findings highlight the critical role of GLP-1 in the impaired counterregulatory response to hypoglycemia in T1DM patients and provide new insights into the potential application of GLP-1-related therapies in T1DM patients.

Diabetes-inducing effects of bronchial asthma

BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.

Clinical study on the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes

BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.

Current perspectives and the future of disease-modifying therapies in type 1 diabetes

Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.

Influence of gut bacteria on type 2 diabetes:Mechanisms and therapeutic strategy

The onset and progression of type 2 diabetes mellitus(T2DM)are strongly associated with imbalances in gut bacteria,making the gut microbiome a new potential therapeutic focus.This commentary examines the recent publication in World Journal of Diabetes.The article explores the association between T2DM and gut microbiota,with a focus on the pathophysiological changes related to dysbiosis.It proposes innovative microbiome-targeted therapeutic strategies and evaluates the challenges and future directions of such approaches.This editorial summarizes the key points of their discussion of the role of the gut microbiome in T2DM and elaborates on the influence of specific gut microbial species on the disease through the host–microbiota metabolic axis.It provides new insights for future research on gut-microbiota-based interventions for T2DM.