Search Results (1,036)

Background: Obstructive sleep apnea (OSA) is increasingly recognized as a systemic disorder associated with insulin resistance and elevated risk of type 2 diabetes. While continuous positive airway pressure (CPAP) is the standard therapy, its long-term metabolic benefits remain inconsistent. The metabolic impact of upper airway surgery is less well defined. Methods: In this retrospective study, 49 patients with polysomnography-confirmed OSA who underwent upper airway surgery were evaluated. Respiratory and metabolic parameters—including apnea–hypopnea index (AHI), fasting plasma glucose, fasting insulin, glycated hemoglobin (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR)—were assessed preoperatively and at 6 months postoperatively. Associations between changes in AHI (ΔAHI) and insulin resistance (ΔHOMA-IR) were analyzed using correlation and receiver operating characteristic (ROC) analyses. Results: Significant improvements were observed in both respiratory and metabolic parameters. AHI decreased from 46.6 ± 25.8 to 20.7 ± 14.1 events/h (p < 0.001). Fasting plasma glucose, insulin levels, and HOMA-IR were significantly reduced postoperatively (all p < 0.05), while HbA1c showed a downward trend. Reduction in AHI was moderately correlated with improvement in insulin resistance (r = 0.527, p < 0.001). ROC analysis demonstrated modest discriminative ability of ΔAHI for identifying normalization of insulin resistance (AUC = 0.62). Conclusions: Upper airway surgery was associated with significant improvements in insulin resistance and glycemic parameters in patients with OSA. The correlation between airway improvement and metabolic change supports a physiological link between upper airway obstruction and insulin sensitivity. These findings suggest that upper airway surgery may represent a clinically relevant adjunct within multimodal strategies for metabolic risk reduction, particularly in patients unable to tolerate CPAP therapy. Full article

Objective: TNFSF13B, which encodes B-cell-activating factor (BAFF) and peptidylarginine deiminase 4 (PADI4), plays crucial roles in the pathogenesis of ANCA-associated vasculitis (AAV). This study investigated the associations of single-nucleotide polymorphisms (SNPs) in TNFSF13B/BAFF and PADI4 genes with AAV susceptibility, clinical phenotypes, and disease activity in a Guangxi Chinese population. Methods: A case–control study included 324 AAV patients and 324 healthy controls. After propensity score matching (201 pairs), genomic DNA was genotyped for TNFSF13B/BAFF rs3759467 (formerly rs386492354) and rs1041569, and PADI4 rs11203366 and rs874881 using multiplex PCR and high-throughput sequencing. Genetic associations were analyzed via logistic regression, subgroup, haplotype, and clinical correlation analyses. For each of the four SNPs separately, machine learning models (logistic regression, SVM, Random Forest, XGBoost) were built and evaluated via 5-fold cross-validation. No formal adjustment for multiple comparisons was applied due to the exploratory nature of this study. Results: For TNFSF13B/BAFF, the rs3759467 C allele was protective (dominant model OR = 0.60, p = 0.011; log-additive OR = 0.71, p = 0.020; CA haplotype OR = 0.71, p = 0.019), while the rs1041569 T allele was a risk factor (dominant model OR = 1.70, p = 0.016). Subgroup analysis revealed stronger protective effects of rs3759467 in females, Han ethnicity, and MPA patients, and stronger risk effects of rs1041569 in Han ethnicity and MPA patients. Haplotype CA was protective (OR = 0.71, p = 0.019), and TT was risk-associated (OR = 1.55, p = 0.017). Both TNFSF13B/BAFF SNPs were associated with rash and hemoptysis incidence (p < 0.05). rs1041569 was also associated with RBC (red blood cell) count and HB (hemoglobin) levels (p < 0.05). For PADI4, rs11203366 and rs874881 showed no association with AAV susceptibility (all p > 0.05). However, their genotypes were associated with disease activity (BVAS, Birmingham Vasculitis Activity Score), RBC count, and HB levels (p < 0.05). Although machine learning was applied to explore predictive patterns, its performance was suboptimal (AUC < 0.6), indicating limited clinical applicability. Accordingly, the primary findings rely on the genetic model analysis, and the machine learning results should not be overinterpreted as clinically actionable. SHAP analysis indicated that risk-associated genotypes contributed most to model predictions. Conclusions:TNFSF13B/BAFF gene polymorphisms rs3759467 and rs1041569 were associated with AAV susceptibility in this Guangxi cohort, influencing clinical manifestations like rash, hemoptysis, and anemia severity. PADI4 polymorphisms rs11203366 and rs874881 are not associated with susceptibility but may correlate with disease activity and hematological parameters. These findings highlight the ethnic and clinical subtype specificity of genetic influences in AAV. Due to the lack of external validation, these findings are exploratory and require replication. Full article

Background/Objectives: Obesity-related insulin resistance is accompanied by chronic low-grade inflammation, but the extent to which weight loss modifies circulating cytokines in a sex-specific manner remains insufficiently understood. The aim of this study was to assess sex-specific cytokine responses and metabolic adaptation in adults with obesity and insulin resistance following a six-month weight-reduction program (WRP). Methods: Thirty-six participants (24 women and 12 men) with a value of Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) ≥ 2 underwent an individualized low-calorie diet combined with moderate physical activity and health education. Anthropometric, body composition, biochemical, oxidative stress, and cytokine parameters were evaluated before and after the intervention. Results: Both women and men showed significant reductions in body mass, Body Mass Index (BMI), waist circumference, visceral fat area (VFA), body fat mass (BFM), fasting glucose, HOMA-IR, modified Atherogenic Index of Plasma (new-AIP), malondialdehyde (MDA), and Oxidative Stress Index (OSI). Women additionally showed significant decreases in fat-free mass (FFM), skeletal-muscle mass (SMM), total body water (TBW), glycated hemoglobin A_1c (HbA1c), and triacylglycerols, whereas cholesterol in high-density lipoproteins (HDL-C) increased significantly in men. Cytokine changes were selective rather than uniform. Interleukin-1 receptor antagonist (IL-1ra), Interleukin 6 (IL-6), and Tumor Necrosis Factor alpha (TNF-α) decreased in both women and men. In sex-stratified analyses, IL-1β decreased significantly only in women, whereas IL-7 decreased significantly only in men. ClinicalTrials.gov Registration: [NCT07645105] (retrospectively registered on [11 June 2026]). Conclusions: A 6-month lifestyle-based weight-reduction program in adults with overweight or obesity and insulin resistance was associated with metabolic improvement, reduced oxidative stress, and partial attenuation of obesity-related low-grade inflammation. The observed cytokine and metabolic changes suggest sex-related patterns of immunometabolic adaptation to weight reduction. However, these findings should be interpreted cautiously because of the relatively small sex-stratified subgroups and the number of cytokine endpoints analyzed, and they require confirmation in larger, sex-balanced studies. Full article

Background/Objectives: HbA1c is widely used to identify adults at increased risk of type 2 diabetes mellitus (T2DM), but major guidance differs on whether the lower limit of an HbA1c-defined risk range should be 5.7% (39 mmol/mol) or 6.0% (42 mmol/mol). This systematic review evaluated the prognostic and screening utility of HbA1c 5.7–6.4% compared with HbA1c 6.0–6.4% and examined whether available evidence supports threshold-based allocation of preventive interventions. Methods: The review was reported in accordance with PRISMA 2020 and registered in PROSPERO (CRD42019134344). PubMed/MEDLINE, Embase and the Cochrane Library were searched for studies published from 1 January 2016 to 1 January 2026. Eligible evidence comprised human studies in English, French, Hebrew, Italian or Spanish that evaluated HbA1c ranges below the diabetes diagnostic threshold in adults aged at least 40 years or younger adults with established risk factors. Two reviewers independently screened records and extracted data. Risk of bias was assessed using an adapted QUADAS-2 framework for threshold-performance evidence, supplemented by CASP-informed appraisal, and certainty was rated with GRADE domains. Narrative synthesis was selected because populations, thresholds, comparator tests, follow-up and outcome ascertainment were heterogeneous. Results: Seven studies were included. Evidence consistently supported a graded risk continuum rather than a single biological cut point. HbA1c 5.7–6.4% identifies more adults but includes many at low short-term absolute risk, whereas HbA1c 6.0–6.4%, especially 6.2–6.4% or combined HbA1c and fasting glucose abnormality, identifies fewer adults at higher near-term risk. Direct evidence comparing 5.7% versus 6.0% thresholds came mainly from one UK cohort, with supportive but indirect evidence from meta-analysis, routine-care cohorts and reversion studies. No trial randomized adults to intervention by HbA1c threshold, and eligible evidence did not directly address early diabetes-related morbidity by threshold. Conclusions: HbA1c below the diabetes diagnostic threshold should be interpreted as risk strata, not as a binary disease label. HbA1c 5.7–6.4% is defensible for broad, low-intensity preventive advice, while HbA1c 6.0–6.4% can be used to prioritize structured prevention and closer follow-up. The proposed tiered approach is a pragmatic, hypothesis-generating interpretation of the available evidence rather than a trial-validated intervention algorithm. Full article

Background and Objectives: Anemia is a common complication of chronic kidney disease (CKD) and is associated with reduced quality of life, accelerated disease progression, and increased cardiovascular risk. Sodium–glucose cotransporter-2 inhibitors (SGLT2is) have demonstrated significant renal and cardiovascular benefits, and clinical trials have reported improvements in hematologic parameters during treatment. However, real-world evidence regarding their longitudinal effects on hemoglobin (Hb) and iron metabolism in patients with CKD remains limited. Materials and Methods: We conducted a pre–post analysis of 118 adult patients with CKD stages 1–4 treated with SGLT2is (empagliflozin or dapagliflozin) at the University Clinical Center of Serbia between January 2024 and June 2025. Patients received either agent at 10 mg once daily for 18 months. Hb, ferritin, C-reactive protein (CRP), albumin (Alb), daily proteinuria (Prt), and estimated glomerular filtration rate (eGFR) were assessed at baseline and at 18 months. Ferritin was adjusted for inflammatory and nutritional status using a residualization model incorporating CRP and Alb. Changes between the two time points were analyzed using repeated-measures general linear models (GLMs). Results: In unadjusted analyses, mean Hb increased modestly from 136.5 ± 17.9 g/L at baseline to 138.8 ± 18.9 g/L at follow-up (p = 0.028), while median ferritin decreased from 102.2 µg/L to 89.9 µg/L (p = 0.011). After adjustment for CRP and Alb, ferritin levels remained unchanged (p = 0.752). Repeated-measures analyses showed no significant longitudinal effect of time on Hb or ferritin and no significant interaction between time and SGLT2i type. Baseline eGFR, Prt, sex, and baseline ferritin significantly influenced longitudinal hematologic trajectories. Conclusions: SGLT2i therapy was associated with modest increases in Hb levels over 18 months, while inflammatory status remained stable and no significant reduction in ferritin levels was observed after adjustment for inflammatory and nutritional factors. Longitudinal Hb and ferritin trajectories did not differ significantly between empagliflozin and dapagliflozin, while baseline kidney function, Prt, iron status, and sex significantly influenced hematologic outcomes. Although causal inference is limited by the absence of a control group, these findings suggest a possible favorable effect of SGLT2is on anemia-related parameters in patients with CKD. Full article

Introduction: Glycemic control in patients with type 2 diabetes mellitus undergoing intermittent hemodialysis represents a clinical challenge. The pathophysiological alterations inherent to chronic kidney disease (CKD) and the dialysis procedure limit the usefulness of traditional metrics. In this context, continuous glucose monitoring (CGM) enables dynamic assessment of glycemic profiles and can reveal patterns of dysglycemia that go undetected in routine clinical practice. Methods: An observational, cross-sectional, and analytical pilot study involved 10 patients from the hemodialysis (HD) unit. CGM was carried out for 14 days. A paired analysis was performed to compare glycemic parameters on days with and without HD. Statistical evaluation was performed using the Shapiro–Wilk test and Student’s t-test; a p-value < 0.05 indicated statistical significance. Results: Time in range (TIR) showed considerable interindividual variability (24–100%), with hyperglycemia being the predominant factor. During HD sessions, glucose levels showed a marked intradialytic decline followed by incomplete post-dialysis recovery, a pattern that differed from non-dialysis days (paired t-test, p < 0.001; n = 10 paired observations). These findings should be interpreted as exploratory. Hypoglycemic episodes were infrequent, whereas persistent hyperglycemia prevailed. Conclusions: CGM reveals metabolic dysregulation frequently overlooked by traditional indicators such as glycated hemoglobin (HbA1c). These exploratory findings suggest that CGM may provide clinically relevant information in this population, although larger studies are needed before therapeutic recommendations can be established. Full article

Background/Objectives: Advanced technologies in type 1 diabetes mellitus (T1DM) management have reshaped the strategies used to achieve optimal glucose control. Continuous subcutaneous insulin infusion (CSII) and automated insulin delivery (AID) systems are effective alternatives to multiple daily injections (MDI). This study aims to evaluate glycemic regulation in children and adolescents transitioning from MDI to insulin pumps and to raise awareness among patients and their families regarding the benefits of these systems. Methods: 50 pediatric patients with T1DM (24 males, 26 females; mean age 10.76 ± 3.2 years) were evaluated. Cycle 1 established MDI metrics 3 months pre-transition. In cycle 2, patients transitioned either to an AID system (Medtronic MiniMed 780G, (Northridge, CA, USA), 78%), or a non-automated system (Omnipod DASH, 22%). Data were assessed at 3 and 6 months post-initiation. Parameters assessed were glycosylated hemoglobin (HbA1c), time in range (TIR), time above range (TAR), time below range (TBR), glucose management indicator (GMI) and coefficient of variation (CV). Results: The cohort exhibited a statistically significant increase in TIR (p = 0.0038) with mean values of 70.9% at 3 months and 73.2% at 6 months. TAR significantly reduced (p = 0.033) to 26.5% and 24.3% at 3 and 6 months, respectively. Sub-analysis in the AID group revealed a marked increase in TIR (p = 0.0001) alongside significant reductions in TAR (p = 0.0009) and GMI (p = 0.03). Conclusions: Transitioning from MDI to insulin pump therapy, particularly AID systems, leads to modest but significant improvements in specific sensor metrics (TIR, TAR) in real-world clinical practice. The consistency of these results across age groups indicates that AID systems can successfully overcome pediatric and adolescent diabetes management challenges. Full article

Background: Post-COVID syndrome represents a significant medical and public health challenge, particularly among older adults and individuals with type 2 diabetes mellitus (T2DM), in whom disturbances in immune and metabolic homeostasis may contribute to the development and persistence of symptoms following SARS-CoV-2 infection. Objective: To investigate the clinical, immunological, and metabolic characteristics of post-COVID syndrome in older adults with T2DM. Methods: A cross-sectional comparative study was conducted involving 141 patients aged ≥ 60 years who were evaluated more than one year after SARS-CoV-2 infection. Clinical data, anthropometric measurements, complete blood count parameters, biochemical markers, glycated hemoglobin (HbA1c), and SARS-CoV-2-specific IgG antibodies were assessed. Statistical analyses were performed using nonparametric methods, while Pearson’s χ² test was applied for categorical variables. A p-value < 0.05 was considered statistically significant. Results: Symptoms consistent with post-COVID syndrome one year after SARS-CoV-2 infection were identified in 53.2% of participants. No significant differences in anthropometric characteristics, hematological parameters, or most biochemical markers were observed between patients with and without post-COVID syndrome. Patients with T2DM exhibited higher fasting glucose, HbA1c, and SARS-CoV-2–specific IgG antibody levels, reflecting underlying metabolic characteristics and differences in humoral immune responses during the late post-COVID period. Conclusions: Post-COVID syndrome symptoms were frequently observed among older adults at the time of assessment, more than one year after SARS-CoV-2 infection, despite normalization of most laboratory parameters. In patients with T2DM, higher glucose, HbA1c, and antibody levels likely reflect underlying metabolic characteristics rather than a direct effect of post-COVID syndrome. Further longitudinal studies are warranted to clarify the long-term clinical significance of the observed metabolic and immunological findings. Full article

Background/Objectives: Advanced glycation end-products (AGEs) are implicated in the vascular complications of type 2 diabetes mellitus (T2DM). Although the Mediterranean diet (MD) confers well-recognized benefits, adherence among people with T2DM is moderate. Evidence regarding the relationship between adherence to the MD and AGEs remains limited. This study aimed to investigate the association between adherence to the MD and AGE levels in individuals with T2DM in Greece. Methods: Adults with T2DM were enrolled in this cross-sectional study. Ocular and skin AGEs were assessed using autofluorescence techniques, while serum AGEs were quantified using an enzyme-linked immunosorbent assay (ELISA). MD adherence was scored with the Mediterranean Diet Score (MedDietScore) (range 0–55). Results: Sixty-one individuals were studied (mean age: 65 ± 9 years; 35 men). Median glycated hemoglobin (HbA1c) and MedDietScore were 6.95 (6.2–7.5)% and 29.0 (27.5–31.5), respectively. Higher adherence to the MD was more frequent among women (p = 0.019) and was associated with lower HbA1c levels (p = 0.002). MedDietScore was inversely correlated with HbA1c (ρ = −0.437, p < 0.001), ocular AGEs (ρ = −0.435, p = 0.013), and skin AGEs (ρ = −0.309, p = 0.033). In multivariable regression analyses, higher adherence to the MD was independently associated with lower ocular (p = 0.043) and skin AGEs (p = 0.005). Conclusions: Higher adherence to the MD was associated with female sex and lower HbA1c. MedDietScore was inversely related to skin, and ocular AGE levels in individuals with T2DM. Full article

Background/Objectives: Uncontrolled diabetes and associated comorbidities disproportionately affect African American (AA) adults. Medication adherence is key to diabetes control yet is often suboptimal, particularly among AA adults. This study examined associations between patient characteristics and adherence among AA adults with uncontrolled diabetes and compared two medication adherence instruments for predicting diabetes control. Methods: This cross-sectional analysis used baseline data from the Management of Diabetes in Everyday Life (MODEL) study, a clinical trial to improve diabetes self-care among AA adults with uncontrolled diabetes. Internal consistency of the 12-item Adherence to Medication Refills and Medications Scale for diabetes medications (ARMS-D) was evaluated by comparing its Cronbach α to the standardized Cronbach α calculated from MODEL data. Associations with variables were examined using correlations, t-tests, or ANOVA, as appropriate. Stepwise multiple regression identified predictors of diabetes control assessed by hemoglobin A1c (HbA1c). Results: Among 665 participants (mean age = 54 years, HbA1c = 10.24%; 67% female; 73% high health literacy), 75% reported perfect adherence on the Summary of Diabetes Self-Care Activities Medications Subscale (SDSCA-MS) versus 7.3% on ARMS-D. ARMS-D showed strong internal consistency (α = 0.81). Lower adherence by ARMS-D was associated with younger age, higher social complexity, and depression (all p ≤ 0.001). ARMS-D score, age, depression, and insulin, dipeptidyl peptidase 4 inhibitor, and sodium-glucose co-transporter 2 inhibitor use predicted baseline HbA1c. Conclusions: This study demonstrates that younger age, depression, and high social complexity are associated with lower medication adherence measured using the ARMS-D. Adherence gaps identified by ARMS-D may validly predict diabetes control and help guide interventions to improve diabetes care in AA adults with uncontrolled diabetes. Full article

Individuals with type 2 diabetes mellitus (T2D) are at increased cardiovascular risk. Although exercise is an important strategy for reducing cardiometabolic risk, accessible and scalable intervention delivery strategies, such as synchronous telehealth programs, remain underexplored. This randomized clinical trial (RED Study; NCT05362071) investigated the effects of a 12-week synchronous telehealth exercise program on clinical, functional, and psychosocial outcomes in adults with T2D. Thirty-three participants (55.8 ± 10.1 years) were randomized to an intervention group (INT; n = 17), which performed supervised combined aerobic and resistance exercise via video calls (2–3 sessions/week), or a control group (CON; n = 16). Glycated hemoglobin (HbA1c) was the primary outcome. Secondary outcomes included capillary blood glucose, blood pressure, functional performance, and psychosocial parameters. Assessments were conducted at baseline and post-intervention by blinded evaluators, and analyses were conducted using linear mixed-effects models in an intention-to-treat analysis. No significant interaction effect was observed for HbA1c (p > 0.05). However, significant group × time interactions favored the INT for functional performance outcomes, including the 30 s Chair Stand (p = 0.02), Arm Curl (p < 0.001), Timed Up and Go (p = 0.01), and 2-Minute Step Test (p = 0.01), as well as sleep quality (p < 0.001). Depressive symptoms decreased over time (p = 0.03) in both groups. Additionally, the INT showed reductions in post-session capillary blood glucose across mesocycles 1, 2, and 4 (p = 0.03). The synchronous telehealth exercise program was not superior to the control condition in reducing HbA1c; however, it improved functional performance, enhanced sleep quality, and promoted acute reductions in glycemic levels in individuals with T2D. Full article

Background and Objectives: Obesity and insulin resistance are major contributors to cardiometabolic disease and type 2 diabetes mellitus (T2DM). This study evaluated the real-world effects of semaglutide on metabolic parameters, body composition, and cardiometabolic risk factors in people with obesity, with and without T2DM, and explored predictors of treatment response. Materials and Methods: This retrospective longitudinal observational study included 70 adults with obesity (42 with T2DM and 28 without T2DM) treated with semaglutide according to current clinical guidelines. The primary outcomes were changes in body weight, waist circumference, fasting plasma glucose, and glycated hemoglobin (HbA1c). Secondary outcomes included changes in lipid profile, insulin resistance indices, inflammatory markers, hepatic parameters, and body composition assessed by bioelectrical impedance analysis (InBody770). Results: Semaglutide treatment was associated with significant reductions in body weight (−9 kg), waist circumference (−8 cm), HbA1c (−1.1%), systolic blood pressure (−7.5 mmHg), visceral fat area (−30.1 cm²), and insulin resistance markers. Improvements in glycemic parameters were more pronounced in participants with T2DM. Skeletal muscle mass (SMM) was relatively preserved during treatment. Baseline HbA1c and visceral adiposity were independently associated with metabolic response. Conclusions: In this real-world observational cohort, semaglutide was associated with significant improvements in metabolic parameters, body composition, and cardiometabolic risk markers in people with obesity, with and without T2DM. Baseline metabolic characteristics may influence treatment response. Full article

Background: Gestational diabetes mellitus (GDM) adversely affects offspring neurobehavioral outcomes, yet evidence regarding continuous markers of maternal glucose metabolism remains limited. Although polyunsaturated fatty acids (PUFAs) have been shown to affect associations between glucose metabolism and respiratory outcomes, their effects on children’s emotional and behavioral problems remain unclear. This study investigated the association between maternal glucose metabolism and emotional and behavioral problems in children and the potential modifying effect of maternal erythrocyte PUFAs. Methods: This prospective birth cohort included 481 mother–child pairs. Maternal glucose metabolism during pregnancy was assessed using GDM diagnosis via a 75 g oral glucose tolerance test (OGTT), fasting plasma glucose (FPG), 1 h and 2 h OGTT glucose, hemoglobin A1c (HbA1c), insulin, and insulin resistance (HOMA-IR). Maternal erythrocyte PUFAs were quantified by gas chromatography. Children’s emotional and behavioral problems at age 5 years were assessed using the Strengths and Difficulties Questionnaire (SDQ). Generalized linear models were used to evaluate associations, including multiplicative interaction terms between glucose metabolism indicators and PUFAs. Results: Maternal FPG (OR = 1.63; 95%CI: 1.08–2.47), OGTT-1h glucose (OR = 1.84; 95%CI: 1.08–3.12), and HOMA-IR (OR = 1.52; 95%CI: 1.01–2.27) were each positively associated with an increased risk of abnormal total difficulties scores in children. Maternal insulin levels were positively associated with abnormal total difficulties scores in girls (p for interaction < 0.05). Higher maternal n-3 PUFA levels and lower n-6 PUFA levels attenuated the risk of glucose metabolism-related emotional and behavioral problems in children. Conclusion: Maternal glucose metabolism was associated with increased risk of emotional and behavioral problems in children. PUFA biomarkers could modify glucose-related emotional and behavioral outcomes in children. Full article

Objective: Insulin resistance is a key pathophysiological driver linking obesity and type 2 diabetes (T2D) with cardiovascular risk. Composite surrogate indices derived from routine clinical parameters, such as the Metabolic Score for Insulin Resistance (METS-IR) and the Single Point Insulin Sensitivity Estimator (SPISE), may provide a practical means of capturing multidimensional metabolic changes. Given that comparative data are limited, we aimed to evaluate the effects of sodium–glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) on these indices in individuals with T2D and overweight or obesity. Methods: In this retrospective observational study, 100 individuals with T2D treated with either GLP-1RA (n = 54) or SGLT2i (n = 46) were evaluated over 6 months. Strict inclusion criteria ensured treatment stability without initiation or modification of concomitant pharmacotherapy. Changes in METS-IR and SPISE were assessed alongside body mass index (BMI) and glycated hemoglobin (HbA1c). Multivariable regression and exploratory analyses, including stratification by BMI and correlation analyses, were performed. Results: Both treatment groups demonstrated significant improvements in METS-IR (GLP-1RA: −3.9 ± 5.9; SGLT2i: −2.5 ± 2.6; both p < 0.001) and SPISE (GLP-1RA: +0.46 ± 0.52; SGLT2i: +0.44 ± 0.61; both p < 0.001), with no significant between-group differences. In the GLP-1RA group, changes in METS-IR correlated with changes in BMI (r = 0.48, p < 0.001) and HbA1c (r = 0.29, p = 0.030), whereas no significant correlations were observed in the SGLT2i group. Stratified analyses indicated greater reductions in METS-IR among individuals with BMI ≥30 kg/m² treated with GLP-1RA. Conclusions: Both SGLT2i and GLP-1RA improve composite surrogate markers of insulin resistance, with distinct associations with weight and glycemic changes. METS-IR and SPISE may serve as practical tools for monitoring multidimensional metabolic responses in clinical practice. Full article

Aims: Murine studies show a promising effect of high-fiber β-glucan on glycemic control and serum lipids. In addition, β-glucan has recently been found to have strong antioxidant and immunomodulatory effects. Oat flakes are a natural source of β-glucan. However, the effects of oat flakes on glycemic variability, dyslipidemia, and pancreatic duodenum homeobox-1 (PDX-1) levels in type 1 diabetes (T1D) remain unclear. Hence, this study assessed the effect of oat flakes on glycemic variability, dyslipidemia, and PDX-1 among adolescents with T1D. Materials and Methods: Sixty adolescents with T1D were divided into 2 equally matched groups. Group A received oat flakes β-glucan 6 g per day for 3 months in addition to an ordinary diet and insulin regimen. Group B received an ordinary diet and insulin regimen. This was followed by crossing over both arms for another 3 months after a two-week washout period. All participants underwent auxological assessment, continuous glucose monitoring (CGM), hemoglobin A1c (HbA1c), fasting lipids, and PDX-1 measurements at baseline, 3 months, and 6 months. Results: Oat flakes consumption resulted in a significant decrease in the coefficient of variation, HbA1c, serum cholesterol, triglycerides, and LDL-C levels (p < 0.001), with a significant increase in TIR, HDL-C, and PDX-1 levels (p < 0.001). However, all these effects waned after the stoppage of the oat flakes, except for HDL-C. Conclusions: Oat flakes have a favorable outcome on glycemic metrics, lipid profile, and PDX-1 in adolescents with T1D. Full article