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Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges: 2nd Edition

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A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 31 March 2026 | Viewed by 6716

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Special Issue Editors

Dr. Daniela Maria Tanase

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Department of Internal Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 University Street, Iasi, Romania
Interests: cardiovascular diseases; cardiovascular complications; atherosclerosis; oxidative stress; inflammatory bowel disease; nonalcoholic fatty liver disease; gut microbiota; dysbiosis; type 2 diabetes.
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Mariana Floria

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Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: arrhythmias; atrial fibrillation; left atrium; cardiovascular disease; cardiovascular risk factor; echocardiography; gastroesophageal reflux disease; metabolic disease
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Prof. Dr. Ionela Lacramioara Serban

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Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: endothelial dysfunction; oxidative stress; atherosclerosis; molecular biology; inflammatory diseases; cardiovascular diseases; type 2 diabetes
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Special Issue Information

Dear Colleagues,

After the success of the first edition of this Special Issue, we intend to publish a second edition, and we invite you to submit your research for publication.

https://www.mdpi.com/journal/life/special_issues/W64SCZA0W3

Diabetes mellitus, a complex syndrome characterized by abnormalities in every aspect of cellular energy metabolism, and its complications are one of the most important health problems in the world. The major pathophysiological mechanisms underlying the pathogenesis of diabetes mellitus and its complications involve insulin resistance, immunological defect, an impaired incretin effect, gluco- and lipotoxicity, inflammation, oxidative stress, endoplasmic reticulum stress, defective autophagy mechanisms, proapoptotic pathways, modification of the intestinal microbiome, and abnormal mitochondrial function in insulin-sensitive tissues such as the liver, skeletal muscle, adipose tissue, blood vessels, the nervous system, and the myocardium.

In recent years, evidence-based treatment algorithms have been proposed for patients with diabetes, focusing on patients comorbidities as a critical determinant of the selection of the most appropriate treatment. Nowadays, it is widely recognized that diabetes mellitus is associated not only with cardiovascular mortality, but also with poor quality of life due to its association with chronic kidney disease, sarcopenia, cancer, and dementia. To overcome these problems, it is important to better understand the disease process of diabetes and its complications and develop new treatment strategies. Acute complications include hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar state, and hyperglycemic diabetic coma. Chronic vascular (chronic microvascular complications: nephropathy, neuropathy and retinopathy; chronic macrovascular complications: coronary artery disease, peripheral arterial disease and cerebrovascular disease) and non-vascular complications are also involved.

The purpose of this Special Issue is to provide a platform to disseminate knowledge about diabetes. We invite submissions of both original research and comprehensive review articles. Potential topics include, but are not limited to, the following:

Work on the molecular mechanisms of diabetes-related diseases;
Potential new biomarkers for the prediction of diabetes and its complications;
Physiopathological concepts related to the mechanisms described above;
Innovative diagnostic tools and technologies for early detection, risk assessment, and monitoring;
Diabetes and metabolic syndrome;
Diseases associated with diabetes (vascular and non-vascular complications);
Advancements in pharmacological and non-pharmacological approaches to improve treatment outcomes and treatment strategies (medical nutrition, metabolic surgery, drugs, and innovative approaches based on nanotechnology or artificial intelligence) in the context of precision diabetology.

Dr. Daniela Maria Tanase
Prof. Dr. Mariana Floria
Prof. Dr. Ionela Lacramioara Serban
Guest Editors

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 250 words) can be sent to the Editorial Office for assessment.

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. Life is an international peer-reviewed open access monthly 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

hyperlipidemia
neuropathy
nephropathy
retinopathy
psychological effects
epigenetic imprinting
molecular profiling
glucose control
vascular damage and regeneration
diabetes complications

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Research

15 pages, 552 KB

Open AccessArticle

The Association Between the Triglyceride–Glucose Index and the Risk of Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

by Munther S. Momani, Raneem Dalaeen, Dia Sarhan, Zaid Sarhan, Suhib Awamleh, Yazan M. Momani and Omar Abu Farsakh

Life 2026, 16(2), 345; https://doi.org/10.3390/life16020345 - 17 Feb 2026

Viewed by 469

Abstract

This study aimed to evaluate the association between the triglyceride–glucose index (TyG) and the risk of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus. Methods: This study included 1347 patients with type 2 diabetes who attended the endocrinology clinic at Jordan University Hospital between May 2025 and October 2025. Medical records were reviewed to identify patients with documented DKD, and the TyG index was calculated for each patient. Results: Our results showed that patients with both late-stage kidney disease (mean 9.47 ± 0.74) and early-stage kidney disease (mean 9.42 ± 0.67) demonstrated elevated TyG index values compared to those without kidney disease (mean 9.27 ± 0.70). In the fully adjusted model, the association remained robust with an OR of 1.611 (95% CI: 1.330–1.951, p < 0.001), indicating that higher TyG index values are independently associated with increased kidney risk even after controlling for major confounding variables. When comparing TyG index quartiles, the second quartile showed no significant difference from the reference group, while the third quartile showed 66% increased odds (OR = 1.66, 95% CI: 1.176–2.345, p = 0.004) and the fourth quartile demonstrated 117% increased odds (OR = 2.174, 95% CI: 1.512–3.125, p < 0.001). The association between the TyG index and DKD was more significant in patients younger than 60 years, and in women. In conclusion, the TGI was associated with increased risk of DKD; however, its discriminative ability was modest (AUC 0.57). This indicates that the TGI alone is insufficient as a predictive tool and should be interpreted alongside established screening tools. Prospective studies are needed to clarify its causal role in DKD development. Full article

(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges: 2nd Edition)

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17 pages, 547 KB

Open AccessArticle

Brainstem Raphe Echogenicity and Insomnia in Type 2 Diabetes: An Exploratory Cross-Sectional Study

by Maarja Randväli, Kaja Mädamürk, Jekaterina Šteinmiller and Toomas Toomsoo

Life 2026, 16(2), 298; https://doi.org/10.3390/life16020298 - 9 Feb 2026

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Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with increased vulnerability to depression and other affective disturbances, potentially mediated by neurobiological alterations in the serotonergic brainstem raphe nuclei. This study examined whether raphe hypoechogenicity, assessed by transcranial sonography, is associated with depressive, anxiety, and sleep-related symptoms in individuals with T2DM, and whether such alterations are linked to diabetes-related complications. Methods: This cross-sectional study included 230 participants with T2DM and non-diabetic controls. Raphe echogenicity was assessed using transcranial sonography (TCS), and mental health outcomes were measured with the Patient Health Questionnaire 9 (PHQ-9) and the Emotional Well-Being Questionnaire (EWQ). To address demographic imbalance, analyses were repeated in a propensity score–adjusted subsample (n = 89). Results: Raphe hypoechogenicity was associated with higher insomnia scores (EWQ6; β = 0.67, p = 0.01); however, this association was attenuated to non-significance after adjustment for sleep medication use and did not survive correction for multiple comparisons, and no associations were observed with PHQ-9 or other EWQ subscales. The participants with hypoechogenic raphe also exhibited a higher prevalence of other diabetes-related complications (32% vs. 7%, p = 0.03). Conclusions: In this exploratory cross-sectional sample, reduced raphe echogenicity was not associated with overall depressive or anxiety symptom severity, but was associated with higher self-reported sleep-related symptom burden. However, this association was not robust to adjustment for sleep medication use or to correction for multiple comparisons. These findings are hypothesis-generating and require replication in larger, longitudinal and medication-naive cohorts using standardized sleep instruments. Full article

(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges: 2nd Edition)

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12 pages, 317 KB

Open AccessArticle

Expanding the Use of Continuous Glucose Monitoring in Type 2 Diabetes Mellitus: Impact on Glycemic Control and Metabolic Health

by Mi-Joon Lee, Bum-Jeun Seo and Jae-Hyoung Cho

Life 2025, 15(10), 1543; https://doi.org/10.3390/life15101543 - 1 Oct 2025

Viewed by 3820

Abstract

This study aims to investigate the effects of continuous glucose monitoring (CGM) on glycemic control in patients with diabetes mellitus (DM) and to identify the sociodemographic or health behavioral factors that influence the outcomes. The data were collected from 510 diabetic patients prescribed to use CGM for 12 weeks and analyzed using SPSS 27.0. Paired samples t-tests were used to compare the glycemic control (HbA1c and fasting glucose) and metabolic health (body mass index and total cholesterol) measures of subjects before and after the CGM use, and independent t-tests were conducted to examine whether the effectiveness of CGM differs according to subjects’ sociodemographic and health behavioral characteristics. As a result of this study, the use of CGM resulted in a significant reduction in HbA1c from 8.09 to 7.48 percent (p < 0.001) and in fasting glucose from 152.41 to 137.16 mg/dL (p < 0.001). In the subgroup analysis of CGM effectiveness, fasting glucose reduction was greater in females than in males and in patients with type 2 diabetes than in those with type 1 diabetes. In conclusion, it is essential to consider patient characteristics to enhance the effectiveness of CGM and to expand its use to type 2 diabetes to reduce the social burden of the disease. Full article

(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges: 2nd Edition)

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22 pages, 85025 KB

Open AccessArticle

Atorvastatin Confers Renoprotection and Modulates Inflammation in Diabetic Rats on a High-Fat Diet

by Minela Aida Maranduca, Andreea Clim, Daniela Maria Tanase, Cristian Tudor Cozma, Mariana Floria, Ioana Adelina Clim, Dragomir Nicolae Serban and Ionela Lacramioara Serban

Life 2025, 15(8), 1184; https://doi.org/10.3390/life15081184 - 25 Jul 2025

Cited by 2 | Viewed by 1620

Abstract

Objective: Uncovering the renoprotective and anti-inflammatory effects of atorvastatin treatment in diabetic-and-obese rats by employing traditional renal function indicators (urea and creatinine) and four prototypical cytokines (IL-1β, il-6, IL-17α, TNFα). Method: Twenty-eight male Wistar rats, aged 6 months, 350–400 g, were randomized into four groups. The first group, G-I, the denominated control, were fed standard chow over the whole course of the experiments. The rodents in G-II were exposed to a High-Fat Diet. The last two groups were exposed to Streptozotocin peritoneal injection (35 mg/kg of body weight). A short biochemical assessment was performed before diabetes model induction to ensure appropriate glucose metabolism before experiments. Following model induction, only rodents in group G-IV were gradually introduced to the same High-Fat Diet as received by G-II. Model confirmation 10 days after injections marked the start of statin treatment in group G-IV, by daily gavage of atorvastatin 20 mg/kg of body weight/day for 21 days. At the end of the experiments, the biochemical profile of interest comprised typical renal retention byproducts (urea and creatinine) and the inflammatory profile described using plasma levels of TNFα, IL-17α, IL-6, and IL-1β. Results: Treatment with Atorvastatin was associated with a statistically significant improvement in renal function in G-IV compared to untreated diabetic rodents in G-III. Changes in inflammatory activity showed partial association with statin therapy, TNFα and IL-17α mirroring the trend in urea and creatinine values. Conclusions: Our results indicate that atorvastatin treatment yields a myriad of pleiotropic activities, among which renal protection was clearly demonstrated in this model of diabetic-and-obese rodents. The statin impact on inflammation regulation may not be as clear-cut, but the potential synergy of renal function preservation and partial tapering of inflammatory activity requires further research in severely metabolically challenged models. Full article

(This article belongs to the Special Issue Interdisciplinary Approach to Diabetes Mellitus: From Pathophysiology to Diagnosis and Therapeutic Challenges: 2nd Edition)

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