micro-community-banner
 
  • Saved

1mo
A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial - PubMed

A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/41067715/

RR2-10.3390/ijerph192214706.

In this cluster randomized trial, a personalized SMS-based intervention with optional provider training modestly reduced HbA1c levels in prediabetic patients without statistical significance, but improved patient engagement and perceived behavioral support.

  • Saved

1mo
Macrophage polarization in diabetic vascular complications: mechanistic insights and therapeutic targets - PubMed

Macrophage polarization in diabetic vascular complications: mechanistic insights and therapeutic targets - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/41044593/

Diabetes mellitus, particularly type 2 diabetes mellitus, is a widespread chronic metabolic disorder characterized by persistent hyperglycemia and low-grade chronic inflammation. This sustained inflammatory state is a major driver of...

This review explores macrophage polarization in diabetic vascular complications, detailing the roles of M1/M2 phenotypes, signaling pathways, and emerging therapies that target macrophage modulation to mitigate vascular inflammation and tissue damage.

  • Saved

2mo
Personalized diets may rebalance hormones and reduce obesity-related health risks

Obesity disrupts endocrine health through insulin resistance, chronic inflammation, and altered adipokine signaling. This narrative review explores how different dietary patterns influence hormonal balance in men and women.

Highlights:

  • In men, obesity is linked to decreased testosterone, reduced thyroid function, possibly reflecting thyroid hormone resistance, and elevated cortisol
  • In women, it increases risks for PCOS, infertility, and androgen excess
  • Calorie restriction, low-carbohydrate diets, Mediterranean, and plant-based patterns show hormonal benefits
  • Hormonal effects of dietary changes are often sex-specific

What sets this study apart:

Unlike conventional reviews that focus on single nutrients, this synthesis examines whole dietary patterns and their interaction with sex-specific hormonal physiology. It emphasizes the importance of individualized nutrition plans based on reproductive and metabolic profiles, underscoring that one-size-fits-all approaches are inadequate for endocrine health.

Limitations:

As a narrative review, conclusions are drawn from existing literature rather than new clinical data. Long-term outcomes and sustainability of restrictive diets, such as ketogenic or very low-carbohydrate regimens, remain underexplored.

What role does gender play in how dietary choices influence endocrine health?

  • Saved

2mo
case study

 

Patient Background

A 61-year-old woman with type 2 diabetes (T2D) presents six months after a myocardial infarction (MI). She reports exertional fatigue and mild evening ankle swelling. She monitors her glucose inconsistently and believes her diabetes is well controlled.

Medical History

  • Comorbidities: Hypertension, dyslipidemia, stage 2 chronic kidney disease (CKD)
  • Cardiac history: Non–ST elevation MI with stent placement; currently on dual antiplatelet therapy
  • Medications: Metformin, ACE inhibitor, statin, beta-blocker, dual antiplatelet therapy
  • Lifestyle: Non-smoker, limited physical activity, diet partially modified after MI

Vitals & Exam

  • BMI: 30.6 kg/m²
  • Blood pressure (BP): 136/80 mm Hg
  • Heart: Regular rhythm, no murmurs
  • Lungs: Clear
  • Extremities: Trace pedal edema

Recent Labs

  • eGFR: 63 mL/min/1.73 m²
  • Urinary albumin-to-creatinine ratio (UACR): 120 mg/g
  • Low-density lipoprotein cholesterol (LDL-C): 68 mg/dL
  • Hemoglobin A1c (HbA1c): 6.9%

Assessment & Diagnosis

While HbA1c and LDL-C appear stable, the presence of albuminuria, reduced kidney function, and prior MI highlights persistent residual risk not captured by glycemic control alone. These findings underscore the overlap of cardiovascular and renal disease and the likelihood of recurrent CV events and CKD progression.

Guideline updates emphasize a shift from focusing solely on glycemic targets to broader outcome-based care, with greater attention to kidney and cardiovascular health. These insights reinforce the importance of early recognition of risk factors and continued monitoring to prevent progression.

Although her labs suggest relative stability, her overall profile signals significant residual risk. Multidisciplinary input from cardiology, nephrology, and endocrinology will be important in guiding long-term care decisions.

  1. How would you approach care for a patient with T2D, prior MI, and early CKD?
  2. How do you integrate multidisciplinary perspectives in managing long-term residual risk?
  • Saved

2mo
Improving 10-year cardiovascular risk prediction in patients with type 2 diabetes with metabolomics - PubMed

Improving 10-year cardiovascular risk prediction in patients with type 2 diabetes with metabolomics - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/39806417/

Incorporating seven metabolomic biomarkers in the SCORE2-Diabetes model enhanced its ability to predict MACE in patients with type 2 diabetes. Given the latest cost reduction and standardization efforts, NMR metabolomics...

Adding seven NMR-derived metabolomic biomarkers improved 10-year MACE prediction in type 2 diabetes beyond SCORE2-Diabetes, supporting metabolomics’ clinical utility in cardiovascular risk stratification.