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Epidemiology, Complications and Management of Diabetes
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Epidemiology, Complications and Management of Diabetes

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (20 April 2023) | Viewed by 3848

Special Issue Editor

Prof. Dr. Farid M. Nakhoul

E-Mail Website
Guest Editor
1. The Cardiovascular and Diabetes Lab, Research Institute, The Galilee Medical Center, Nahariya, Israel
2. The Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
Interests: diabetic nephropathy; autophagy; α-klotho; SGLT2Is

Special Issue Information

Dear Colleagues,

Type II diabetes mellitus (T2DM) is a severe metabolic disorder, characterized by chronic hyperglycemia associated with increased glucose cell toxicity, that leads to irreversible renal and pancreatic cell damage. Autophagy/klotho pathways play a key role in damaged intracellular protein degradation, intracellular homeostasis, and cell integrity maintenance. Recent studies have shown a decrease in α-klotho and autophagy proteins (ATG5/LC3-II) as well as in the expression of DMs' kidney and pancreatic β cells. Both α-klotho and autophagy key proteins (ATG5/LC3-II) can play a protective role against DM complications, such as diabetic nephropathy. Empagliflozin, a sodium–glucose transporter-2 inhibitor, is currently used for patients with T2DM to lower plasma glucose levels and normalize HbA1C, yet it bears pleiotropic effects on kidney and pancreatic β cells.

Chronic glucose exposure damages renal epithelial and β cells via the downregulation of klotho and autophagy processes. Recently, autophagy and klotho processes were identified as two protective pathways that can maintain renal and pancreas integrity as well as function, especially via the involvement of their key proteins, ATG5/LC3-II. Recently, new antidiabetic drugs, sodium–glucose transporter-2 inhibitors (SGLT2Is), showed beneficial protective effects in T2DM and DN patients by reducing proteinuria and slowing GFR deterioration (4). SGLT2Is, such as empagliflozin (EMPA), also supported human islet function in vivo in the hyperglycemic milieu and potentially promoted α to β cell transdifferentiation, most likely through an indirect mechanism.

Prof. Dr. Farid M. Nakhoul
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diabetic nephropathy
  • autophagy
  • ATG5-LC3-II
  • α-klotho
  • empaglifozin

Published Papers (2 papers)

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Research

12 pages, 1733 KiB  
Article
Changes in Serum Creatinine May Cause Hypoglycemia among Non-Critically Ill Patients Admitted to Internal Medicine Units
by Boris Zingerman, Israel Khanimov, Mordechai Shimonov, Mona Boaz, Benaya Rozen-Zvi and Eyal Leibovitz
J. Clin. Med. 2022, 11(22), 6852; https://doi.org/10.3390/jcm11226852 - 20 Nov 2022
Viewed by 1508
Abstract
Background: The association between changes in serum creatinine levels and hypoglycemia during hospitalization was investigated. Methods: This was a retrospective analysis of medical charts. Patients were categorized as having significant change in creatinine (SCIC) when serum creatinine levels rose or dropped ≥ 0.3 [...] Read more.
Background: The association between changes in serum creatinine levels and hypoglycemia during hospitalization was investigated. Methods: This was a retrospective analysis of medical charts. Patients were categorized as having significant change in creatinine (SCIC) when serum creatinine levels rose or dropped ≥ 0.3 mg/dL from admission values at any time during their hospitalization. Patients were considered hypoglycemic if they had at least one documented glucose level ≤ 70 mg/dL during the hospitalization. Multiple logistic, linear and Cox regression analyses were used to ascertain the association between incident SCIC, severity and timing with incident hypoglycemia. Results: Included were 25,400 (mean age 69.9 ± 18.0, 49.3% were males). The rate of SCIC was 22.2%, and 62.2% of them were diagnosed upon admission. Patients with SCIC had a higher incidence of hypoglycemia compared to patients without (13.1% vs. 4.1%, respectively, p < 0.001). Patients with SCIC had an increased risk of hypoglycemia (OR 1.853, 95% CI 1.586–2.166, p < 0.001). The magnitude of SCIC was associated with the incidence (OR 1.316, 95% CI 1.197–1.447, p < 0.001) and the number of events (HR 0.054, 95% CI 0.021–0.087, p = 0.001). More than 60% of patients with hypoglycemia had their first event documented during days 0–6 after SCIC occurrence. Of those, the majority of events occurred on day 0–1, and the rate showed a gradual decrease throughout the first 5 days from SCIC occurrence. The results were similar for patients with and without DM. Conclusions: Changes in creatinine during hospitalization may cause hypoglycemia among patients admitted to internal medicine departments, regardless of DM status. Full article
(This article belongs to the Special Issue Epidemiology, Complications and Management of Diabetes)
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9 pages, 1372 KiB  
Article
Recent Trends in Diabetes-Associated Hospitalizations in the United States
by Muni Rubens, Venkataraghavan Ramamoorthy, Anshul Saxena, Peter McGranaghan and Elise McCormack-Granja
J. Clin. Med. 2022, 11(22), 6636; https://doi.org/10.3390/jcm11226636 - 9 Nov 2022
Cited by 6 | Viewed by 1920
Abstract
The purpose of this study was to examine trends in diabetes-related hospitalizations over the period 2010 to 2019 using Nationwide Inpatient Sample (NIS) to facilitate informed policies regarding diabetes-related prevention and management. Between 2010 and 2019, there were 304 million hospitalizations above 18 [...] Read more.
The purpose of this study was to examine trends in diabetes-related hospitalizations over the period 2010 to 2019 using Nationwide Inpatient Sample (NIS) to facilitate informed policies regarding diabetes-related prevention and management. Between 2010 and 2019, there were 304 million hospitalizations above 18 years of age, of which 78 million were diabetes-associated hospitalizations. The overall population-adjusted diabetes hospitalizations significantly increased from 3079.0 to 3280.8 per 100,000 US population (relative increase, 6.6%, Ptrend < 0.028). Age-stratified analysis showed that hospitalizations significantly increased for 18–29 years (relative increase, 7.8%, Ptrend < 0.001) while age- and gender-stratified analysis showed that diabetes hospitalization significantly increased for 18–29-year males (relative increase, 18.1%, Ptrend < 0.001). Total hospitalization charge increased from 97.5 billion USD in 2010 to 132.0 billion USD in 2019 (relative increase, 35.4%, Ptrend < 0.001). Our study’s findings suggest that diabetes-associated hospitalizations will continue to increase in the future because recent evidence indicates a reappearance of diabetes complications. It is important to screen, prevent, and control diabetes at a younger age based on the trends observed in our study. Full article
(This article belongs to the Special Issue Epidemiology, Complications and Management of Diabetes)
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