Diabetes and pulmonary infection:how hyperglycaemia shapes the immune system

In a recent study published in Nature,Nobs and colleagues aimed to identify novel mechanisms that may explain why diabetes is associated with an increased susceptibility to viral respiratory infections.Their analyses revealed a central role of lung dendritic cells(DC)which exhibited several functional defects induced by hyperglycaemia and consequently result in impaired antiviral immune responses.

Type 2 diabetes across populations of different ancestry: deconstructing the genomic landscape

In a recent study published in Nature Medicine,Smith and colleagues used data from 1.4 million individuals across 37 genome-wide association studies(GWAS)reflecting different genetic ancestral populations to identify 12 genetic clusters,mostly shared among the different populations,and associated the weighted sums of genetic variants of each cluster—termed as partitioned polygenic scores(pPSs)—with various lab-based,anthropometric and cardiometabolic traits.Their analyses extended previous studies on biological mechanisms linking genetics to type 2 diabetes(T2D)risk and pointed to both similarities of genetic clusters across multiple populations and differences regarding their contributions to overall T2D risk among different ethnicities.

Early detection of neuropathy in leprosy:a comparison of five tests for field settings

Background:Early detection and treatment of neuropathy in leprosy is important to prevent disabilities.A recent study showed that the Nerve Conduction Studies(NCS)and Warm Detection Thresholds(WDT)tests can detect leprosy neuropathy the earliest.These two tests are not practical under field conditions,however,because they require climate-controlled rooms and highly trained staff and are expensive.We assessed the usefulness of alternative test methods and their sensitivity and specificity to detect neuropathy at an early stage.Methods:Through a literature search we identified five alternative devices that appeared user-friendly,more affordable,portable and/or battery-operated:the Neuropad^(■),Vibratip^(TM),NC-Stat^(■)DPNCheck^(TM),NeuroQuick and the Thermal Sensibility Tester(TST),assessing respectively sweat function,vibration sensation,nerve conduction,cold sensation and warm sensation.In leprosy patients in Bangladesh,the posterior tibial and sural nerves that tested normal for the monofilament test and voluntary muscle test were assessed with the NCS and WDT as reference standard tests.The alternative devices were then tested on 94 nerves with abnormal WDT and/or NCS results and on 94 unaffected nerves.Sensitivity and specificity were the main outcomes.Results:The NeuroQuick and the TST showed very good sensitivity and specificity.On the sural nerve,the NeuroQuick had both a sensitivity and a specificity of 86%.The TST had a sensitivity of 83%and a specificity of 82%.Both the NC-Stat^(■)DPNCheck^(TM)and Vibratip^(TM)had a high specificity(88%and 100%),but a low sensitivity(16%and 0%).On the posterior tibial nerve,the NeuroQuick and the TST also showed good sensitivity,but the sensitivity was lower than for the sural nerve.The Neuropad^(■)had a sensitivity of 56%and a specificity of 61%.Conclusions:The NeuroQuick and TST are good candidates for further field-testing for reliability and reproducibility.The feasibility of production on a larger scale should be examined.

The sugar-free paradox:cardiometabolic consequences of erythritol

In a recent study published in Nature Medicine,Witkowski and colleagues applied untargeted metabolomics studies in 1157 people at high risk for cardiovascular disease,comprising 22%with diabetes mellitus,followed by quantitative targeted analyses to identify circulating metabolites associated with an increased cardiovascular risk.