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Preprint ARTICLE | doi:10.20944/preprints201703.0153.v1

Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study

Jin-Hyeong Kim, Ju-Hwan Nho, Jae-Woo Choi, Eun-Cheol Park

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes; education; environmental tobacco smoke; smoker

Online: 20 March 2017 (09:09:44 CET)

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Background: Smoking, including environmental tobacco smoke (ETS) exposure is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, also is a risk factor for diabetes. Therefore, we assessed the association of education and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1,325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p<0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p<0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p<0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, no alcohol intake, and no moderate physical activity. For diabetic smokers, there were significant associations (p<0.05) with elementary education, urban residence, lack of moderate physical activity, no alcohol intake, and NHI. Conclusions: The results suggested that smoking status, including ETS exposure, was associated with a higher prevalence of diabetes especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education, and those who are smokers and nonsmokers exposed to ETS.

Preprint REVIEW | doi:10.20944/preprints202306.1306.v1

Exploring Therapeutic Applications of Autophagy in Spike Protein-Related Pathology

Matthew Halma, Paul Marik, Yusuf Saleeby

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Fasting; autophagy; long-COVID; post-vaccination syndrome; spike protein; mitochondria; mitophagy

Online: 19 June 2023 (07:39:57 CEST)

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Preprint REVIEW | doi:10.20944/preprints202306.1903.v1

Exploring Autophagy in Treating Spike Protein-related Pathology

Matthew T.J. Halma, Paul E. Marik, Yusuf M. Saleeby

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Fasting; autophagy; long-COVID; post-vaccination syndrome; spike protein; mitochondria; mitophagy

Online: 27 June 2023 (12:33:46 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201608.0133.v1

Calorie Restriction Supplemented with Fish Oil Ameliorates Abnormal Metabolic Status in Middle-Aged Obese Women: An Open-Label, Parallel-Arm, Controlled Trial

Fasty Arum Utami, Hsiu-Chuan Lee, Chien-Tien Su, Shih-Yi Huang

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: calorie restriction; PUFA; meal replacement; metabolic syndrome; middle age

Online: 13 August 2016 (03:39:38 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201609.0073.v1

Strategies in the Design of Antidiabetic Drugs from Terminalia Chebula Retz. Using in silico and in vitro Approach

Twinkle Bansode, B.K. Salalkar

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes mellitus, molecular docking, thin layer chromatography, alpha amylase, ellagic acid

Online: 20 September 2016 (16:13:12 CEST)

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Preprint REVIEW | doi:10.20944/preprints201811.0171.v1

Microbiota-Gut-Brain-Axis and Autism Spectrum Disorders

Piranavie Srikantha, M. Hasan Mohajeri

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Autism, ASD, microbiota, gut-brain-axis, microbiota-gut-brain-axis, therapy

Online: 7 November 2018 (14:45:10 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202004.0134.v1

Avoiding COVID-19 Complications with Diabetic Patients Could Be Achieved by Multi-Dose Bacillus Calmette–Guérin Vaccine: A Case Study of Beta Cells Regeneration by Serendipity

Bassam M. Ayoub, Eman Ramadan, Nermeen Ashoush, Mariam M. Tadros, Moataz S. Hendy, Mohamed M. Elmazar, Shaker A. Mousa

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: COVID-19; multi-dose BCG; beta cells regeneration; improved C-peptide; serendipity

Online: 9 April 2020 (05:03:24 CEST)

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Diabetes mellitus (DM) is one of the major risk factors for COVID-19 complications as it is one of the chronic immune-compromising conditions especially if patients have uncontrolled diabetes, poor HbA1c &/or irregular blood glucose levels. Diabetic patient’s mortality rates with COVID-19 are higher than cardiovascular or cancer patients. Recently Bacillus Calmette–Guérin (BCG) has shown successful results in reversing diabetes in both rats and clinical trials based on different mechanisms from aerobic glycolysis to Beta cells regeneration. BCG is a multi-face vaccine that has been used extensively in protection from TB and leprosy and has been repositioned for treatment of bladder cancer, diabetes & multiple sclerosis. Recently, the COVID-19 epidemiological study confirmed that universal BCG vaccination reduced morbidity and mortality in certain geographical areas. Countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies that have shown low numbers of reported COVID-19 cases. Some countries have started clinical trials that included a single dose BCG vaccine as prophylaxis from COVID-19 or an attempt to minimize its side effects. This proposed research aims to use BCG vaccine as a double-edged weapon countering both COVID-19 & diabetes, not only as protection but also as therapeutic vaccination. The work includes a case study of regenerated pancreatic beta cells based on improved C-peptide & PCPRI laboratory findings after BCG vaccination for a 9 years’ patient. The patient was re-vaccinated based on a negative tuberculin test & no scar at the site of injection of the 1st BCG vaccination at birth. Furthermore, the authors in the present article described a prospective BCG multi-dose clinical study in full details that they will apply in case of acceptance of their submitted grant & the ethical committee approval. The aim of the clinical study is to check if double dose BCG (4 weeks apart) will show a significant difference in the protection of health care professionals in Egypt. The authors suggest and invite the scientific community to take into consideration the concept of direct BCG re-vaccination (after 4 weeks) because of the reported gene expressions & exaggerated innate immunity consequently. As the diabetic MODY-5 patient (mutation of HNF1B, Val2Leu) was on low dose Riomet® while eliminating insulin gradually, a simple analytical method for metformin assay was recommended to ensure its concentration before use as it is not approved yet by the Egyptian QC labs.

Preprint REVIEW | doi:10.20944/preprints201609.0029.v1

Fundamental Elucidation of HLA in Type 1 Diabetes of Arab Populations

Mohamed Mirza Jahromi

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: HLA; type 1 diabetes; ethnicity; screening; haplotype

Online: 7 September 2016 (12:49:02 CEST)

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Aims/Hypothesis): Type 1 diabetes is an immune-mediated disease with destruction of the pancreatic β-cells, a process that is conditioned by multiple genes and other factors. HLA counts as the major susceptibility gene. Significant variations in HLA genetic susceptibility to type 1 diabetes between Caucasians, African and Asian and other ethnic groups may have led to the variation in incidence of type 1 diabetes globally. Type 1 diabetes is characterized upon HLA identification. In this chapter we discuss global variations in genetic susceptibility of HLA with regard to type 1 diabetes globally with a particular attention to Arab population. Methods): Haplotype configuration of HLA class I A, B, C and Class II –DR/DQ/DP were studied in Caucasians, African and Asian and in Arab population to see if that is responsible for the exponential rise in the rate of type 1 diabetes. Results): Although Arabs have one of the highest global incidence and prevalence rates of type 1 diabetes, unfortunately, there is a dearth amount of information regarding HLA genetic susceptibility to type 1 diabetes in the Arab world. HLA haplotype configurations contribute to its risk value. However, out of an insufficient present study there are examples of misjudgment of HLA risk according to HLA alleles rather than haplotypes. Conclusion): To date HLA outlooks for the characterization of type 1 diabetes. There is an ethnicity difference in HLA characteristics which is responsible for variation in type 1 diabetes. Although Arab population have contributed heavily in the rise of burden of type 1 diabetes, however, there is significantly a dearth amount of studies on HLA in Arab population. Obviously, any future prediction, prevention or cure of the disease will be based on the HLA genetics. There is a dire need for a systematic screening of HLA for Arab population with type 1 diabetes, identification of Arab HLA-risk values and identify those who are prone to get the disease.

Preprint ARTICLE | doi:10.20944/preprints201701.0093.v1

Circulating Docosahexaenoic Acid Associates with Insulin-Dependent Skeletal Muscle and Whole Body Glucose Uptake in Older Women Born from Normal Weight Mothers

Robert M. Badeau, Miikka-Juhani Honka, Marco Bucci, Patricia Iozzo, Johan G. Eriksson, Pirjo Nuutila

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: 22:6 docosahexaenoic acid; ω-3 fatty acids; offspring of obese mothers; offspring of lean mothers; insulin-dependent skeletal muscle glucose uptake

Online: 20 January 2017 (04:59:25 CET)

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Preprint REVIEW | doi:10.20944/preprints201711.0026.v1

Thyroid Disrupting Chemicals

Valeria Calsolaro, Giuseppe Pasqualetti, Filippo Niccolai, Nadia Caraccio, Fabio Monzani

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Thyroid; Thyroid Hormone; Disrupting Compound; Hypothalamus Pituitary Thyroid axis; TSH

Online: 3 November 2017 (12:38:49 CET)

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Preprint ARTICLE | doi:10.20944/preprints201901.0324.v1

The Impact of a Continuous Care Intervention for Treatment of Type 2 Diabetes on Health Care Utilization

Zachary Wagner, Nasir H. Bhanpuri, James P. McCarter, Neeraj Sood

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Type 2 diabetes, health care utilization

Online: 31 January 2019 (08:56:46 CET)

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Introduction: Type 2 diabetes (T2D) is a major driver of health care costs, thus treatments enabling T2D reversal may reduce expenditures. We examined the impact of a T2D continuous care intervention (CCI) on health care utilization. Previous research documented that CCI, including individualized nutrition supported by remote care, simultaneously reduced hemoglobin A1c and medication use and improved cardiovascular status after two years; however, the impact on utilization is unknown. Methods: This study used four years of data (two years pre-intervention, two years post-intervention) from the Indiana Network for Patient Care (INPC) health record. Two methods estimated the impact of CCI on utilization. First, an interrupted time series (ITS) including only CCI participants (n=193) compared post-intervention utilization to expected utilization had the pre-intervention trend persisted. Deviation from the trend was estimated non-parametrically for each 6-month interval after the implementation of CCI . Second, a 1:3 matched comparator group (n=579) was constructed and used for a difference-in-differences (DiD) analysis. The primary outcome was annualized outpatient encounters. Secondary outcomes included emergency encounters and hospitalizations. Results: In two years prior to intervention, CCI participants had a mean of 5.77 annualized encounters (5.62 outpatient, 0.04 hospitalizations, 0.11 emergency). The CCI group showed a reduction in outpatient utilization after intervention. In ITS analysis, 1.6 to 1.9 fewer annualized outpatient encounters occurred in each 6-month interval post-intervention relative to expected utilization based on pre-intervention trends (p<0.01 each 6-month period; 28-33% reduction). The DiD analysis suggested a larger reduction; 5 fewer annualized outpatient encounters in the quarter after intervention, diminishing to 2.5 fewer after 2 years (p<0.01 each quarter). The study was underpowered to draw conclusions about hospitalization and emergency encounters due to the limited number of CCI patients and the rarity of encounters. Conclusions: Outpatient encounters were significantly reduced for a T2D patient population up to 2 years after receiving an individualized intervention supporting nutrition and behavior change through remote care.

Preprint ARTICLE | doi:10.20944/preprints201909.0247.v1

Four‑Stage Evolution of Diabetes or Whole Body Insulin Resistance (WBIR): Debunking of the Lipid‑Induced Insulin Resistance (LIIR) and Proposing of the Glycation‑Induced Insulin Resistance (GIIR)

Song Jae Lee, Sang Won Shin

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: obesity; diabetes; insulin resistance (IR); whole body insulin resistance (WBIR); tissue specific insulin resistance; muscle insulin resistance (MIR); subcutaneous insulin resistance (s AIR); visceral adipose insulin resistance (v AIR); hepatic insulin resistance (HIR)

Online: 21 September 2019 (01:46:31 CEST)

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Even though it has long been known that diabetes develops in distinctive stages over a long span of time, no comprehensive diabetes development model has been developed yet. Insulin resistance (IR) plays a major role in development of diabetes. A widespread belief regarding IR is that it is a global parameter affecting the whole body simultaneously by merely impairing glucose uptake in tissues. However, investigation by a new methodology that we have named integrated approach suggests that IR not merely impairs glucose uptake in tissues but also produces tissue‑specific metabolic disruptions varying widely from tissue to tissue, and that IR would not necessarily develop simultaneously over the whole body but instead develop first preferentially in the muscle tissue with a relatively low cell turnover and then progresses in sequence to the subcutaneous adipose tissue to the visceral adipose tissue to the liver with higher cell turnovers. This is the most important rationale for subdividing IR into the four distinct tissue‑specific IRs: muscle insulin resistance (MIR), subcutaneous adipose insulin resistance (s‑AIR), visceral adipose insulin resistance (v‑AIR), and hepatic insulin resistance (HIR). Sequential development of tissue‑specific IRs, in the order of MIR, s‑AIR, v‑AIR, and HIR, producing tissue‑specific metabolic disruptions is nothing but the whole body insulin resistance (WBIR) evolving in four distinctively insulin‑resistant stages. Four‑stage evolution from rapid weight gain to visceral obesity to rapid weight loss to full‑blown diabetic state not only complies well with the natural development history of diabetes, but also resolves most of controversies on diabetes or obesity. Development of the four‑stage WBIR evolution model, which also refutes the entrenched notion of the lipid‑induced insulin resistance (LIIR) but instead supports the glycation‑induced insulin resistance (GIIR) proposed in this study, may possibly be considered a breakthrough in study of diabetes or obesity.

Preprint ARTICLE | doi:10.20944/preprints201910.0276.v1

Two-step Randomisation: Applying the Results of Small Feasibility Studies of Interventions to Large-scale Mendelian Randomisation Studies to Robustly Infer Causal Effects on Clinical Endpoints

Meda R Sandu, Rhona Beynon, Rebecca Richmond, Diana L. Santos Ferreira, Lucy Hackshaw-McGeagh, George Davey Smith, Chris Metcalfe, J Athene Lane, Richard Martin

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: epidemiology; causality; cancer; methodology; mendelian randomisation; randomised controlled trials

Online: 24 October 2019 (10:53:36 CEST)

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Background: Feasibility trials are preliminary trials that assess the viability and acceptability of intervention studies and the effects of the intervention on intermediate endpoints. Due to their short duration, they are unable to establish the effects of the intervention on long-term clinical outcomes. We propose a novel method that could transform the interpretation of feasibility trials using modified two-stage randomisation analyses. Methods In this two-stage process, we explored the effects of a 6-month feasibility factorial randomised controlled trial (RCT) of lycopene and green tea dietary interventions (ProDiet) on 159 serum metabolic traits in 133 men with raised PSA levels but prostate cancer (PCA) free. In the first stage, we conducted an intention-to-treat analysis, using linear regression to examine the effects of the interventions on metabolic traits, compared to the placebo group and instrumental variable analysis to assess the causal effect of the intervention on the outcomes. In the second stage, we used a two-sample Mendelian Randomization (MR) approach to assess the causal effect of metabolic traits altered by the interventions, on PCA risk, using summary statistics data from an international PCA consortium of 44,825 cancer cases and 27,904 controls. ResultsThe systemic effects of lycopene and green tea supplementation on serum metabolic profile were comparable to the effects of the respective dietary advice interventions (R2= 0.65 and 0.76 for lycopene and green tea respectively). Metabolites which were altered in response to lycopene supplementation were acetate (standard deviation difference versus placebo (β)): 0.69; 95% CI= 0.24, 1.15; p=0.003), valine (β: -0.62; -1.03, -0.02; p=0.004), pyruvate (β: -0.56; -0.95, -0.16; p=0.006), and docosahexaenoic acid (β: -0.50; -085, -0.14; p=0.006). The instrumental variable analysis showed there was no evidence that green tea altered the metabolome, but lycopene was associated with an increase in acetate (β=2.13; p=0.006) and decreases in pyruvate (β=-1.90; p=0.009), valine (β=-1.79; p=0.023), diacylglycerol (β=-1.81; p=0.026), alanine (β=-1.55; p=0.015) and DHA (p=0.097), where the regression coefficient represents the standard deviation (SD) difference in metabolite measures per unit change in lycopene (µmol/L) or EGCG (nM).Using MR, a genetically instrumented SD increase in pyruvate increased the odds of PCA by 1.29 (1.03, 1.62; p=0.027). Conclusion Using a two-stage randomization analysis in a feasibility RCT, we found that lycopene lowered levels of pyruvate, which our Mendelian randomization analysis suggests may be causally related to reduced PCA risk.

Preprint ARTICLE | doi:10.20944/preprints201802.0187.v1

Body Mass, Total Body Fat and Visceral Fat Percentage Predict Insulin Resistance Better Than Waist Circumference and Body Mass Index in Healthy Young Male Adult in Indonesia

Liong Boy Kurniawan, Uleng Bahrun, Mochammad Hatta, Mansyur Arif

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: insulin resistance; body weight; body fat; visceral fat; waist circumference; body mass index

Online: 28 February 2018 (04:43:50 CET)

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Preprint ARTICLE | doi:10.20944/preprints201901.0288.v1

Diagnostic Accuracy and Feasibility of Point-Of-Care Glycosylated Hemoglobin Estimation in Field Conditions in India

Sagar Khadanga, Abhijit Pakhare, Rajnish Joshi

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: HbA1c; point-of-care; diabetes; glycosylated haemoglobin

Online: 29 January 2019 (08:06:18 CET)

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Preprint ARTICLE | doi:10.20944/preprints201910.0191.v1

Identification of Epigenetic Interactions between MicroRNA and DNA Methylation Associated with Polycystic Ovarian Syndrome

Zhanrui Mao, Ting Li, Hui Zhao, Yulan Qin, Yani Kang

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: polycystic ovarian syndrome; granulosa cells; microrna regulation; dna methylation; biomarker

Online: 17 October 2019 (12:30:58 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201901.0145.v1

Double Discourse: Perspectives on Breast Screening Participation among Women and Their Health Care Providers

Kate A McBride, Catharine AK Fleming, Emma S George, Genevieve Z Steiner, Freya MacMillan

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: obesity; breast screening; mammograms; health service utilization;

Online: 15 January 2019 (09:10:11 CET)

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Preprint ARTICLE | doi:10.20944/preprints201909.0247.v2

Four‑Stage Evolution of Diabetes or Whole Body Insulin Resistance (WBIR): Debunking of the Lipid‑Induced Insulin Resistance (LIIR) and Proposing of the Glycation‑Induced Insulin Resistance (GIIR)

Song Jae Lee, Sang Won Shin

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: obesity; obesity paradox; diabetes; insulin resistance (IR); whole body insulin resistance (WBIR); tissue-specific insulin resistance; muscle insulin resistance (MIR); subcutaneous insulin resistance (s-AIR); visceral adipose insulin resistance (v-AIR); hepatic insulin resistance (HIR); lipid-induced insulin resistance (LIIIR); glycation-induced insulin resistance (GIIIR)

Online: 9 October 2019 (04:21:56 CEST)

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Even though it has long been known that diabetes develops in distinctive stages over a long span of time, no comprehensive diabetes development model has been developed yet. Insulin resistance (IR) plays a central role in development of diabetes. A widespread belief regarding IR is that it is a global parameter affecting the whole body simultaneously by impairing merely glucose uptake in tissues. However, the analysis by a new methodology that we have named integrated approach suggests that IR not merely impairs glucose uptake in tissues but also produces tissue-specific metabolic disruptions varying widely from tissue to tissue, and that IR would not necessarily develop simultaneously over the whole body but instead develop first preferentially in the muscle tissue with a relatively low cell turnover and then progress in sequence to the subcutaneous adipose tissue to the visceral adipose tissue to the liver with higher cell turnovers. This is the most important rationale for subdividing IR into four distinct tissue-specific IRs: muscle insulin resistance (MIR), subcutaneous adipose insulin resistance (s-AIR), visceral adipose insulin resistance (v-AIR), and hepatic insulin resistance (HIR). Sequential development of tissue-specific IRs, in the order of MIR, s-AIR, v-AIR, and HIR, producing tissue-specific metabolic disruptions, is nothing but the whole body insulin resistance (WBIR) evolving in four distinctively insulin-resistant stages. Four-stage evolution from rapid weight gain to visceral obesity to rapid weight loss to full-blown diabetic state not only complies well with the natural development history of diabetes, but also resolves most of controversies on diabetes or obesity. Development of the four-stage WBIR evolution model, which also refutes the entrenched notion of the lipid-induced insulin resistance (LIIR) but instead supports the glycation-induced insulin resistance (GIIR) proposed in this study, may possibly be considered a breakthrough in study of diabetes as well as obesity.

Preprint ARTICLE | doi:10.20944/preprints201807.0398.v1

Trajectory of Type 2 Diabetes in Sepsis Outcome: Impacts of Diabetic Complication Burdens, Initial Glucose Level, and HbA1c: Population-Based Cohort Study Combining with Nationwide and Hospital-Based Database

Ming-Shun Hsieh, Sung-Yuan Hu, Chorng-Kuang How, Yi-Tzu Lee, Chen-June Seak, Vivian Chia-Rong Hsieh, Jen-Huai Chiang, Chiann-Yi Hsu, Sheng-Hsiang Ma, Pau-Chung Chen

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes mellitus; sepsis; diabetes complication severity index score

Online: 22 July 2018 (10:54:29 CEST)

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Background Diabetic patients have an increased risk of infections; however, the association between type 2 diabetes and hospital outcomes of sepsis remains controversial when the diabetes severity is not considered. We examined this association using nationwide and hospital-based databases concomitantly. Methods The first part of this study was conducted using 2 nationwide databases: the Longitudinal Cohort of Diabetes Patients and the Longitudinal Health Insurance Database 2000. The diabetic complication burden was evaluated using the adapted Diabetes Complications Severity Index score (aDCSI score). In the second part, we used the hospital-based database with laboratory data, such as initial blood glucose and HbA1c levels, to make comparisons between surviving and dead patients with type 2 diabetes and sepsis. Results The nationwide study included 19,719 type 2 diabetic sepsis patients and an equal number of non-diabetic patients. The diabetic sepsis patients had an increased odds ratio (OR) of 1.14 (95% CI 1.1-1.19) for hospital mortality. The OR for mortality increased as the complication burden increased (diabetic sepsis patients with aDCSI scores of 0, 1, 2, 3, 4, and ≥5 had ORs of 0.91, 0.87, 1.14, 1.25, 1.56, and 1.77 for mortality, respectively (all P<0.001 and P for trend <0.001)). A total of 1,054 diabetic sepsis patients were included from the hospital-based database. Initial blood glucose levels in the surviving and dead diabetic sepsis patients did not differ significantly: 273.9 ± 180.3 versus 266.1 ± 200.2 (mg/dL) (P=0.095). Moreover, the surviving diabetic sepsis patients did not have a lower HbA1c (%): 8.4 ± 2.6 versus 8.0 ± 2.5 (P=0.078). Conclusions In the case of type 2 diabetic sepsis patients, the diabetes-related complication burden is the major determinant of hospital mortality rather than the diabetes itself. Contrary to popular belief, initial blood glucose and HbA1c levels may not be as important as previously thought.

Preprint REVIEW | doi:10.20944/preprints201911.0260.v1

Cannabis Sativa Revisited - Crosstalk between microRNAs Expression, Inflammation, Oxidative Stress and Endocannabinoid Response System in Critically Ill Patients with Sepsis

Alexandru Florin Rogobete, Tiberiu Bratu, Ovidiu Horea Bedreag, Marius Papurica, Sonia Elena Popovici, Dorel Sandesc

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: sepsis; endocannabinoid system; cannabinoids; cannabis sativa; THC; CBD

Online: 22 November 2019 (09:32:28 CET)

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Preprint REVIEW | doi:10.20944/preprints202110.0134.v1

The Role of Probiotic Supplementation on Insulin Resistance in Obesity-Associated Diabetes: A Mini-Review

Seeme Saha, Nazmun Nahar Alam, S M Niazur Rahman

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Probiotics; Gut microbiota; Obesity; Insulin resistance; Type 2 Diabetes

Online: 8 October 2021 (10:52:45 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201802.0073.v1

ChREBP Rather than SHP Regulates Hepatic VLDL Secretion

Hiroyuki Niwa, Katsumi Iizuka, Takehiro Kato, Wudeluhu Wu, Hiromi Tsuchida, Ken Takao, Yukio Horikawa, Jun Takeda

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: carbohydrate response element binding protein; small heterodimer partner; microsomal triglyceride transfer protein; very-low-density lipoprotein

Online: 8 February 2018 (16:27:41 CET)

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Preprint ARTICLE | doi:10.20944/preprints201906.0280.v1

Effects of Breast Cancer and Type 2 Diabetes Mellitus on Pulmonary Volumes and Pressures in Adult Women

Rodrigo Muñoz Cofré, Mariano del Sol, Gonzalo Palma Rozas, Washington Valverde Ampai, Daniel Conei Valencia, Gabriel Nasri Marzuca-Nassr, Paul Medina González, Máximo Escobar Cabello

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes mellitus; breast cancer; pulmonary volumes

Online: 27 June 2019 (06:08:48 CEST)

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Working Paper ARTICLE

Obesity and Telomere Length: Does the Obesity Paradox Exist?

Jin-Hee Kim, Hae-Jin Ko, A-Sol Kim, Ha-Na Moon, Hye-In Choi, Ji-Yeon Park, Sung-Kook Lee, Hee-Jung Yoon

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Body mass index, Metabolic syndrome, Obesity, Obesity paradox, Telomere, Waist circumference, Waist-to-hip ratio, Waist-to-height ratio

Online: 4 September 2019 (14:20:32 CEST)

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Background Telomere shortening is related to aging and unfavourable health outcomes. Obesity and metabolic diseases are important factors for accelerating aging. This study aimed to find out the association between obesity, metabolic disease, and telomere length in metabolically healthy adults. Methods 237 adults were enrolled with written consents at a health promotion centre of a tertiary hospital from February 2014 to March 2015. After excluding 99 subjects who met the exclusion criterion, a total of 130 metabolically healthy subjects were selected for final analysis. The subjects were divided into quartile groups according to the telomere lengths of their oral mucosal cells. Results The subjects consisted of 66 (50.8%) males with a mean age of 58.59 years. The body mass index (BMI, kg/m2) increased significantly along with the quartile groups (Q1, 23.00; Q2, 23.96; Q3, 23.70; Q4, 25.20; P-for trend=0.008). Waist circumference (WC, P-for trend=0.022), waist-to-hip ratio (WHR, P-for trend=0.005), and waist-to-height ratio (WHtR, P=0.001) also increased along with the quartile groups. Obesity prevalence (BMI ≥25 kg/m2), abdominal obesity (WC ≥90 cm for men, ≥85 cm for women), WHR 〉1.0 for men or 〉0.85 for women, and WHtR ≥0.5 increased significantly as the telomere length increased (P-for trend <0.05). After adjusting for covariates, the ORs for each obesity markers increased as the telomere length increased (P-for trend <0.05); and the ORs of WHtR were especially meaningful (Q1, 1.00; Q2, 2.53; Q3, 2.97; Q4, 7.81; P-for trend = 0.001). There were no significant trends for metabolic syndrome and its components along with the prevalence of fatty liver disease. Conclusion Obesity markers and telomere length had significant positive correlation despite the established theory. The obesity paradox may exist in metabolically healthy adults with regard to telomere length, However, further studies with larger sample sizes for the association between obesity and telomere length are needed.

Working Paper ARTICLE

A Novel Multi-Biomarker Assay for Non-Invasive Quantitative Monitoring of Kidney Injury

Drew Watson, Joshua Y.C. Yang, Reuben D. Sarwal, Tara K. Sigdel, Juliane Liberto, Izabella Damm, Devon Livingstone, Katherine Soh, Arjun Chakraborty, Michael Liang, Pei-Chen Lin, Victoria Louie, Shristi Sigdel, Minnie M. Sarwal

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: KIT assay; chronic kidney disease; biomarker; non-invasive; urine; eGFR; cfDNA

Online: 20 March 2019 (02:12:19 CET)

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The standard of care measures for kidney function, proteinuria, and serum creatinine (SCr) are poor predictors of early stage kidney disease. Measures that can detect chronic kidney disease in its earlier stages are needed to enable therapeutic intervention and reduce adverse outcomes of chronic kidney disease. We have developed the Kidney Injury Test (KIT) and a novel KIT Score based on the composite measurement and validation of multiple biomarkers across a unique set of 397 urine samples. The test is performed on urine samples that require no processing at the site of collection and without target sequencing or amplification. We sought to verify that the pre-defined KIT test, KIT Score, and clinical thresholds correlate with established chronic kidney disease (CKD) and may provide predictive information of early kidney injury status above and beyond proteinuria and renal function measurements alone. Statistical analyses across six DNA, protein, and metabolite markers were performed on a subset of residual spot urine samples with CKD that met assay performance quality controls from patients attending the clinical labs at the University of California, San Francisco (UCSF) as part of an ongoing IRB approved prospective study. Inclusion criteria included selection of patients with confirmed CKD and normal healthy controls; exclusion criteria included incomplete or missing information for sample classification, logistical delays in transport/processing of urine samples or low sample volume, and acute kidney injury. Multivariate logistic regression of kidney injury status and likelihood ratio statistics were used to assess the contribution of the KIT Score for prediction of kidney injury status and stage of CKD as well as assess the potential contribution of the KIT Score for detection of early stage CKD above and beyond traditional measures of renal function. Urine samples were processed by a proprietary immunoprobe for measuring cfDNA, methylated cfDNA, clusterin, CXCL10, total protein, and creatinine. The KIT Score and stratified KIT Score Risk Group (High versus Low) had a sensitivity and specificity for detection of kidney injury status (healthy or CKD) of 97.3% (95% CI: 94.6%–99.3%) and 94.1% (95% CI: 82.3%–100%). In addition, in patients with normal renal function [eGFR ≥ 90], the KIT Score clearly identifies those with predisposing risk factors for CKD, which could not be picked up by eGFR or proteinuria (p < 0.001). The KIT Score uncovers a burden of kidney injury that may yet be incompletely recognized, opening the door for earlier detection, intervention and preservation of renal function.

Preprint ARTICLE | doi:10.20944/preprints201803.0085.v1

Can Periodical Examinations of Employees Be Useful in Detection of Glycaemia Impairment and Improving Patients’ Adherence to Medical Recommendations?

Andrzej Marcinkiewicz, Wojciech Hanke, Paweł Kałużny, Agnieszka Lipińska-Ojrzanowska, Marta Wiszniewska, Jolanta Walusiak-Skorupa

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: occupational health; diabetes; glycaemia impairment; impaired fasting glucose; adherence; compliance

Online: 12 March 2018 (07:07:52 CET)

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Preprint REVIEW | doi:10.20944/preprints202006.0061.v1

Analysis of the Effects of Curcuma Longa Supplementation and Physical Exercise in Patients With Diabetes: Systematic Review

Ailton Santos Sena Júnior, Felipe José Aidar, Ana Mara de Oliveira e Silva, Fábio Bessa Lima, Jymmys Lopes dos Santos, Anderson Carlos Marçal

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes; saffron; turmeric; food supplements; supplementation; physical exercise

Online: 7 June 2020 (06:01:12 CEST)

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Preprint REVIEW | doi:10.20944/preprints202109.0288.v1

Role of Diet in Modification of Gut Microbiota in Obesity: Review of Recent Literature

Umama Khan, S M Niazur Rahman, Nazmun Nahar Alam

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diet; Obesity; Gut microbes; High-fiber diet; High fat diet

Online: 16 September 2021 (13:50:36 CEST)

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Preprint REVIEW | doi:10.20944/preprints202303.0361.v1

Inconsistent Outcomes of Metabolic Surgery for Nonobese Patients with Type 2 Diabetes

Kyung Yul Hur

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: inconsistent outcomes; epithelial-mesenchymal crosstalk; altered identity; duodenal-jejunal bypass; biliopancreatic limb; GIP

Online: 21 March 2023 (01:36:35 CET)

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Preprint REVIEW | doi:10.20944/preprints202204.0202.v1

SGLT2 Inhibitors and Potential Applications in Treating Metabolic Syndrome

Clayton Goddard, Karin Allenspach, Audrey Deflandre, Claudine Zemirline, Emilie Guillot, Jonathan P. Mochel

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Metabolic syndrome; SGLT2 inhibitors; Dapagliflozin; Empagliflozin; Canagliflozin; Translational modeling

Online: 21 April 2022 (10:12:04 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202002.0124.v1

Dipeptidyl peptidase-4 inhibitors Mitigates Glycemic Variability in Metformin based Multiple Daily injected Type 2 Diabetes, a Prospective Randomized Controlled Trial

Fukumi Yoshikawa, Hiroshi Uchino, Tomoko Nagashima, Shuki Usui, Masahiko Miyagi, Yasuyo Ando, Naoki Kumashiro, Takahisa Hirose

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: glycemic variability; continuous glucose monitoring; dipeptidyl Peptidase-4 inhibitor; metformin

Online: 10 February 2020 (10:06:31 CET)

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Preprint ARTICLE | doi:10.20944/preprints202201.0078.v1

The Diabetes Transition of Hospital Care (DiaTOHC) Pilot Study: A Randomized Controlled Trial of an Intervention Designed to Reduce Readmission Risk of Adults with Diabetes

Daniel J Rubin, Preethi Gogineni, Andrew Deak, Cherie L Vaz, Samantha Watts, Dominic Recco, Felicia R Dillard, Jingwei Wu, Abhijana Karunakaran, Neil Kondamuri, Huaqing Zhao, Mary D Naylor, Sherita H. Golden, Shaneisha Allen

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: rehospitalization; transition care; pilot study; prospective randomized trial

Online: 6 January 2022 (11:40:43 CET)

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Preprint REVIEW | doi:10.20944/preprints202107.0184.v1

Systematic Review of the Effects of a Dietary Education Intervention on Individuals with Type 2 Diabetes

Ju Ri Kim, Myung-haeng Hur

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetes mellitus; diet, education; systematic review.

Online: 8 July 2021 (09:57:01 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202104.0551.v1

Knowledge, Attitude, and Skill of Family to Treat Elderly with Diabetes Mellitus at Home through the Empowerment of Elderly Cadre in Lampung

Komang Achjar, Dwi Agustanti, Sri Parasitha, Moses Glorino Rumambo Pandin

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Elderly cadres; empowerment; family ability; Lampung

Online: 20 April 2021 (14:24:08 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202202.0307.v1

miR-221-3p/222-3p Cluster Expression in Human Adipose Tissue is Related to Obesity and Type 2 Diabetes

Adriana-Mariel Gentile, Said Lhamyani, Mercedes Clemente-Postigo, Enrique Estepa, Maria Mengual-Mesa, Francisco J. Bermúdez-Silva, Alberto Rodríguez-Cañete, Francisco J. Tinahones, Gabriel Olveira, Rajaa El Bekay

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: miR-221-3p/222-3p cluster; human adipose tissue; obesity; type 2 diabetes

Online: 24 February 2022 (09:54:33 CET)

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Preprint REVIEW | doi:10.20944/preprints202108.0442.v1

Energy Metabolism in Relation to Diet and Physical Activity: A South Asian Perspective

Siti Narsito Wulan, Qaisar Raza, Hera Sisca Pramita, Erryana Martati, Jaya Mahar Maligan, Uma Mageshwari, Itrat Fatima, Guy Plasqui

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: energy metabolism; South Asian; diet; physical activity

Online: 23 August 2021 (13:26:08 CEST)

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Working Paper REVIEW

Commercial and Emerging Technologies for Cancer Diagnosis and Prognosis Based on Exosomal Biomarkers

Nareg Ohannesian, Dilani Gunawardhana, Ibrahim Misbah, Mohsen Rakhshandehroo, Steven H. Lin, Wei-Chuan Shih

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: circulating tumor biomarkers; extracellular vesicles; biological nanoparticles; liquid biopsy; biosensing

Online: 31 January 2020 (05:18:15 CET)

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Preprint ARTICLE | doi:10.20944/preprints202104.0650.v1

Association Between Transcription Factor 7-Like-2 Polymorphisms and Type 2 Diabetes Mellitus in a Ghanaian Population

Christian Obirikorang, Evans Asamoah Adu, Enoch Odame Odame, Emmanuel Acheampong, Lawrence Quaye, Brodrick Yeboah Amoah, Max Efui Annani-Akollor, Aaron Siaw. Kwakye, Foster Fokuoh, Michael Appiah, Eric Nana Yaw Nyarko, Freeman Aidoo, Eric Adua, Eben AFRIFA-YAMOAH, Lois Balmer, Wei Wang

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: TCF7L2, type 2 diabetes mellitus, cardiometabolic risk factors, single nucleotide polymorphisms

Online: 26 April 2021 (10:41:30 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202109.0069.v1

Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study.

Sara Guillen-Aguinaga, Luis Forga, Antonio Brugos-Larumbe, Francisco Guillen-Grima, Laura Guillen-Aguinaga, Ines Aguinaga-Ontoso

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Healthcare Disparities; Diabetes Mellitus, Type 2; Vascular Diseases; Primary Health Care; Cohort

Online: 3 September 2021 (14:58:59 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202108.0506.v1

Tumour Necrosis Receptor Superfamily Interact with the Mitochondrial Dynamics in Adipose Tissue in Obese Patients without Type 2 Diabetes

Daria Shunkina (Skuratovskaia), Alexandra Komar, Maria Vulf, Hung Vu Quang, Egor Shunkin, Elena Kirienkova, Anastasiia Dakchnevich, Danil Malkov, Pavel Zatolokin, Larisa Litvinova

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: NF-kB; non-canonical NF-κB pathway; sTNFR2; sTNFSF8; sTNFSF13; mitochondrial dynamics; fission and fusion; TFAM

Online: 26 August 2021 (11:46:14 CEST)

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Preprint REVIEW | doi:10.20944/preprints202104.0742.v1

The Emerging role of HDACs: Pathology and Therapeutic targets in Diabetes Mellitus

Saikat Dewanjee, Jayalakshmi Vallamkondu, Pratik Chakraborty Chakraborty, Rajkumarsingh Kalra, Moumita Gangopadhyay, Ranabir Sahu, Vijaykrishna Medala, Albin John, P. Hemachandra Reddy, Ramesh Kandimalla

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetes mellitus; Glucose metabolism; Histone deacetylase; HDACs; Histone deacetylase inhibitor; HDACi, Insulin release; Sirtuins, Sirtuin activation

Online: 28 April 2021 (10:23:12 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202107.0415.v1

Associations between Bioactive Algal Biomaterial Supplementation, Dietary Pattern and Metabolic Risk Markers in Japanese Women

Nlandu Roger Ngatu, Tomohiro Hirao, Mitsunori Ikeda

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Adiponectin; Adiponectin modulation inducer; C-reactive protein; Metabolic marker; Sujiaonori.

Online: 19 July 2021 (14:28:52 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202106.0144.v1

Prediction of Female Diabetic Patient in India Using Different Learning Algorithms

Samir Bandyopadhyay, Payal Bose, Vishal Goyel

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetic; Diabetic Mellitus; Diabetic Prediction; PIMA diabetic dataset; Female diabetic Patients; Machine Learning

Online: 4 June 2021 (15:25:16 CEST)

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Preprint REVIEW | doi:10.20944/preprints202202.0180.v1

Redox Homeostasis and Nitro-Oxidative Stress in Obesity-Linked Inflammation

Serge P Bottari, Margaux Di Tommaso, Hanen Samouda

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: oxidative stress; nitrative stress; reactive oxygen species; reactive nitrogen species; nitric oxide inflammation; obesity; peroxynitrite; adipose tissue

Online: 14 February 2022 (16:00:58 CET)

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Preprint ARTICLE | doi:10.20944/preprints202301.0569.v1

A Novel Animal Model in Diabetes Research: Regeneration of β cells in the Axolotl Salamander?

Pernille Lajer Sørensen, Anita Dittrich, Henrik Lauridsen

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes; type 1 diabetes; regeneration; axolotl; salamander; beta cell; beta cell regeneration; streptozotocin

Online: 31 January 2023 (04:11:24 CET)

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Diabetes is a group of diseases characterized by loss of β cell mass and/or -function, resulting in hyperglycemia. Approx. 537 million people worldwide suffer from diabetes – a number which is expected to increase. Diabetes is primarily treated by exogenous insulin, which comes with the challenges of maintaining glycemic control to prevent ketoacidosis and severe complications. The need for a curative treatment has initiated the research in β cell regeneration. Several studies in mice have identified essential genes for β cell fate, which can be manipulated in other cells to induce generation of new β cells. Zebrafish, a regeneration-positive animal model, has shown several different sources of new β cells, including regeneration by self-replication, neogenesis by duct-associated progenitor cells, and transdifferentiation of other endocrine islet cells. The animal models used in this research area are either limited by their low regenerative ability (mice), or their small size and remoteness from humans (zebrafish). There is a need for new animal models of diabetes, in which the molecular pathways of endogenous regeneration can be studied. This study proposes the axolotl salamander (Ambystoma mexicanum) as a model for studying the regeneration of β cells. The axolotl has shown great regenerative capability, as they have proven capable of regenerating amputated limbs, and hearts with myocardial infarction, among other organs. This study aims to establish a diabetic axolotl model, investigate their regenerative ability in the pancreas, and examine the potential systemic effects of the induced disease. In a pilot study, five different protocols using STZ (streptozotocin) were tested, and the most optimal protocol was found. Furthermore, the glucose tolerance test was optimized to characterize the glycemic state of the animals. The effect of the treatment on blood glucose levels was measured to characterize the development and decline of the disease. The histological changes in the pancreas were examined. Moreover, the systemic effects of the STZ treatment were investigated in blood and urine. The study indicated that it is possible to induce diabetes in the axolotl, but variations between the animals should be minimized, or the sample size should be increased to conduct a satisfying experiment, as it was not possible to induce diabetes in all animals. Regeneration was not observed histologically, but a restoration of blood glucose levels was seen over the span of the experiment. Lastly, edema formation was observed in some of the STZ-treated animals, but the cause of edema remains undetermined.

Preprint ARTICLE | doi:10.20944/preprints201808.0491.v1

The Relationship between Carotid Intima-Media Thickness and Serum Secreted Frizzled-Related Protein-4 and Dipeptidyl Peptidase-4 in the Diabetic Patients with Cardiovascular Diseases

Abdulhalim Senyigit, Hafize Uzun, Ilhami Gultepe, Dildar Konukoglu

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: type 2 diabetes mellitus; carotid intima-media thickness; glucagon-like peptide-1; dipeptidyl peptidase-4; clusterin; amylin; secreted Frizzled-related protein-4

Online: 29 August 2018 (09:38:37 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202106.0364.v1

Sonication of Kirschner Wire as a Tool for the Microbiological Diagnosis of Diabetic Foot Infection – Preliminary Results

Rodrigo Cuiabano Paes Leme, Jéssica Chaves, Luiz Carlos Gonçalves, Leonardo César Alvim, João Roberto Chaves de Almeida, Ana Cláudia Couto de Abreu, Leonardo da Cruz Renó

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetic foot infection; biofilm disruption; Kirschner wire; sonication

Online: 14 June 2021 (13:25:16 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202309.0030.v1

Effectiveness of Oral Versus Injectable Semaglutide in Adults with Type 2 Diabetes: Results from a Retrospective Observational Study in Croatia

Sanja Klobučar, Andrej Belančić, Iva Bukša, Nikolina Morić, Dario Rahelić

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: glucagon-like peptide-1; semaglutide; type 2 diabetes

Online: 1 September 2023 (07:49:49 CEST)

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Background: The number of people with type 2 diabetes is increasing daily, and therefore effective therapy is needed to successfully regulate glycemia and reduce the risk of associated complications. Recently, an oral formulation of the glucagon-like peptide-1 receptor agonist (GLP-1 RA) semaglutide has become available. Therefore, the aim of our study was to compare the effectiveness of the new oral formulation and the existing injectable formulation of semaglutide in terms of glycemic and body weight control in a real-world setting. Patients and methods: This was a single-center retrospective observational study conducted at the Rijeka Clinical Hospital Centre. A total of 106 patients with inadequately controlled type 2 diabetes (HbA1 ≥ 7%) on different oral or basal insulin supported oral therapy were recruited from the diabetes outpatient clinic, and data from electronic medical records were retrospectively collected and analyzed from May 2021 to November 2022. All subjects were GLP-1 RA naive and consequently prescribed 0.5 or 1.0 mg once weekly injectable semaglutide (IS) or 7 mg or 14 mg once daily oral semaglutide (OS) for at least 6 months. Glycated hemoglo-bin (HbA1c), body weight, and body mass index (BMI) were assessed prior to semaglutide administration and after a 6-month follow-up period. The primary endpoint was the change from baseline in HbA1c, and sec-ondary endpoints were the change in body weight and the proportion of participants with a reduction in body weight of ≥ 5% and ≥ 10%, respectively, 6 months after the initiation of semaglutide treatment. Results: At 6-month follow-up, no significant difference was observed between the two formulations in terms of HbA1c reduction (IS -1.1% vs OS -1.4%, p=0.126) and weight loss (IS -6.50 kg vs OS -5.90 kg, p=0.714). Exactly the same proportion of participants in both groups achieved a weight loss of ≥ 5% (56.7%, n=30). A weight loss ≥ 10% was observed in 20.7% (n=11) of participants administered IS and 15.1% (n=8) of participants adminis-tered OS, respectively (p=0.454). Conclusion: In a real-world setting, oral semaglutide as add-on therapy to ongoing antihyperglycemic treatment in patients with inadequately controlled type 2 diabetes who had not previously received GLP-1 RA demonstrated the same effectiveness as injectable semaglutide in terms of gly-cemic control and weight loss after 6 months of treatment.

Preprint ARTICLE | doi:10.20944/preprints202111.0217.v1

Accuracy Assessment of the GlucoMen® Day CGM System in Individuals with Type 1 Diabetes: A Pilot Study

Daniel A Hochfellner, Amra Simic, Marlene T Taucher, Lea S Sailer, Julia Kopanz, Tina Pöttler, Julia K Mader

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetes Technology; CGM; Accuracy; Type 1 Diabetes; Sustainability

Online: 12 November 2021 (11:58:57 CET)

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Preprint REVIEW | doi:10.20944/preprints201911.0264.v1

Impact of Glucose-Lowering Medications on Cardiometabolic Risk in Type 2 Diabetes

Angelo Maria Patti, Ali A Rizvi, Rosaria Vincenza Giglio, Anca Pantea Stoian, Daniela Ligi, Ferdinando Mannello

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: cardiovascular risk; dipeptidyl peptidase-4 inhibitors; glucagon like peptide-1 receptor agonists; sodium glucose cotransporter-2 inhibitors; type 2 diabetes mellitus

Online: 24 November 2019 (04:26:47 CET)

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Preprint ARTICLE | doi:10.20944/preprints202006.0283.v1

Increased Aldehyde Formation as a Key Component of the Metabolic Syndrome in Adolescents: A Machine Learning Study

Kamila Bonifacio, Michael Maes, Carine de Farias, Andressa Matsumoto, Crisieli Tomereli, Danilo Pereira da Silva, Edilson Cyrino, Suzana Nixdorf, Danielle Venturini, Decio Barbosa

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Metabolic Syndrome; Obesity; inflammation; Oxidative Stress; nitrosative stress; biomarkers

Online: 23 June 2020 (11:35:38 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202004.0218.v1

Walking Speed is the Sole Determinant of Mild Cognitive Impairment in Japanese Patients with type 2 Diabetes Mellitus

Noritaka Machii, Akihiro Kudo, Haruka Saito, Hayato Tanabe, Mariko Iwasaki, Hiroyuki Hirai, Hiroaki Masuzaki, Michio Shimabukuro

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: type 2 diabetes mellitus; walking speed; sarcopenia

Online: 14 April 2020 (08:45:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202204.0301.v1

Enhancing Night and Day Circadian Contrast through Sleep Nursing Education in Prediabetes and Type 2 Diabetes Mellitus: A Randomized Controlled Trial

Cristina García-Serrano, Jesús Pujol Salud, Lidia Aran Solé, Joaquim Sol, Sònia Ortiz Congost, Eva-Maria Artigues-Barberà, Marta Ortega Bravo

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: glucose metabolism disorders; circadian clocks; sleep; blood glucose; glycated hemoglobin H1Ac

Online: 29 April 2022 (11:38:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202006.0011.v1

High Mobility Group Box 1 and Dickkopf-Related Protein 1 as New Biomarkers of Type 2 Diabetes Mellitus: Associations with Increased Glucose Toxicity and Atherogenicity and Lower β Cell Function

Hussein Kadhem Al-Hakeim, Qasim Jasim Al-Kaabi, Michael Maes

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes mellitus; insulin resistance; inflammation; biomarkers; atherogenicity

Online: 3 June 2020 (05:41:03 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202110.0188.v1

Modifiable Lifestyle Factors and their Relationships with Metabolic Disorders among Adults in Burkina Faso: Findings from the First National Survey

Jeoffray Diendéré, Jean Kaboré, Augustin Nawidimbasba Zeba, William Kofi Bosu, Jérôme Winbetourefa Somé, Franck Garanet, Victor Pingdéwendé Ouédraogo, Abdoul Aziz Savadogo, Athanase Millogo

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Modifiable lifestyle factors; Metabolic disorders; Prevalence; Relationships; Burkina Faso

Online: 12 October 2021 (21:02:23 CEST)

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Preprint REVIEW | doi:10.20944/preprints202306.1578.v1

Gut Microbiome and Diabetes – A Bibliometric and Narrative Review

Ashutosh Mishra, Pallavi Mishra, Vinaytosh Mishra

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Gut Microbiota; Dysbiosis; Endocrine; Diabetes; Therapeutic

Online: 21 June 2023 (16:02:04 CEST)

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Preprint REVIEW | doi:10.20944/preprints202207.0201.v1

Effectiveness of Therapeutic Patient Education Interventions in Obesity and Diabetes: A Critical Systematic Review and Meta-Analysis of Randomized Controlled Trials

Jorge Correia, Ahmed Waqas, Teoh Soo Huat, Karim Gariani, François Jornayvaz, Alain Golay, Zoltan Pataky

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes mellitus; obesity; meta-analysis; patient education; self-management; disease management

Online: 13 July 2022 (15:19:53 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202301.0508.v1

Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study

Abdoulaye Diawara, Djibril Mamadou Coulibaly, Drissa Kone, Mama A. Traore, Dicko S. Bazi, Oumar Kassogue, Djeneba Sylla, Fatoumata Gniné Fofana, Oudou Diabaté, Mamadou Sangaré, Ibrahim Antoine Nieantao, Kaly Keїta, Mamadou Diarra, Jian Li, Cheickna Cisse, Talib Yusuf Abbas, Crystal Zheng, Segun Fatumo, Kassim Traore, Mamadou Wele, Mahamadou Diakité, Seydou O. Doumbia, Jeffrey G. Shaffer

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: cholesterol; cross-sectional study; dyslipidemia; lipids; Mali; type 2 diabetes

Online: 28 January 2023 (01:29:07 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202207.0045.v1

Application of Dehydrated Amniotic Membrane Allografts in Advanced Diabetic Foot Ulceration: Case Report and Review of Literature

Catherine Becker, Justine Davis, Daiyonna Byrd, Anna Colley, Scott Martin, Tyler Barrett

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetic Foot Ulcer; Amniotic Membrane Allograft

Online: 4 July 2022 (09:32:17 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202111.0342.v1

Factors Associated With Chronic Kidney Disease in Patients With Type 2 Diabetes in Bangladesh

Sheikh Mohammed Shariful Islam, Masudus Salehin, Sojib Bin Zaman, Tania Tansi, Rajat Das Gupta, Lingkan Barua, Palash C Banik, Riaz Uddin

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Type 2 Diabetes Mellitus; Chronic Kidney Diseases; Hypertension; Risk Factors; Bangladesh

Online: 19 November 2021 (09:26:12 CET)

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Preprint ARTICLE | doi:10.20944/preprints202307.1982.v2

Exploring the Efficacy of Hormone Replacement Therapy: A Network Meta-Analysis

Gayathri Delanerolle, Julie Taylor, Xiaojie Yang, Ran Zou, Yassine Bouchareb, Heitor Cavalini, Priyanka Jagadeesan, Om Kurmi, Kathleen Riach, Sharron Hinchcliff, Carol Atkinson, Kristina Potočnik, Paula Briggs, Vikram Talaulikar, Lucky Saraswat, Shaheen Khazali, Jian qing Shi, Ashish Shetty, Peter Phiri

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Hormone replacement therapy; Menopause; Cardiovascular disease; Womens Health

Online: 2 August 2023 (10:27:07 CEST)

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Purpose: Hormone Replacement Therapy (HRT), an FDA-approved treatment for menopausal conditions was found to be associated with increased risk of endometrial cancer and reduced oestrogen. Studies showing benefits of HRT in preventing chronic diseases lead to development of clinical guidelines by American College of Physicians. This study aims to assess effectiveness of HRT treatments across cardiometabolic measures including Triglycerides (TG), Follicle-Stimulating Hormone, LDL cholesterol, HDL cholesterol, and Estradiol in menopausal women. It reports gaps in scientific knowledge and clinical practice to enhance current guidelines and policies.Methods: A systematic methodology designed and published in PROSPERO (CRD42022346057) to report network meta-epidemiology analysis was utilised. We used databases by PubMed, Web of Science, ScienceDirect, EMBASE and MEDLINE for studies published between 30th of April 1980-2022. Effects of HRT treatments were explored using a mixed treatment comparison (MTC) model. Fixed and random-effects models were used to address heterogeneity in published studies. Publication bias was assessed and corrected using funnel plots and Egger’s test.Results: Of 45 eligible studies, our findings indicate a significant statistical heterogeneity between HRTs and reduction of TG, SFH, LDL-C alongside increase of HDL-C and Estradiol among menopausal women. The analysis suggests a lack of direct evidence to support their efficacy in reducing TG, SFH and LDL-C levels or to substantiate HRT’s effectiveness in increasing HDL-C and Estradiol. The results showed no significant publication bias in the meta-analysis of included studies.Conclusion: Our findings demonstrate that use of HRT interventions among menopausal women may reduce TG, FSH and LDL-C levels and increase levels of HDL-C and estradiol via oral and oral + transdermal administration. Our study reaffirms efficacy of HRT in supporting favourable lipid profile in menopausal women whilst highlighting the need for robust and inclusive epidemiology studies and clinical trials to further develop clinical guidelines and policies.

Preprint REVIEW | doi:10.20944/preprints201809.0360.v1

p-21 Activated Kinase as a Molecular Target for Chemoprevention in Diabetes

Kyle Dammann, Vineeta Khare, Clyde Coleman, Henrik Berdel, Christoph Gasche

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: p-21 activated kinase; pioglitazone, metformin, type 2 diabetes mellitus, cancer, chemoprevention, and inflammation.

Online: 19 September 2018 (00:50:05 CEST)

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Hypothesis: Anti-diabetic drugs modulate p-21 activated kinase (PAK) signaling Introduction: Type 2 diabetes mellitus (T2DM) is a chronic inflammatory disease associated with increased cancer risk. PAK signaling is implicated in cellular homeostasis when regulated, and cancer when unrestrained. Recent reports provided a role for PAK signaling in glucose homeostasis, but the role of PAKs in the pathogenesis of T2DM is unknown. Here we performed a mini-meta analysis to explore if anti-diabetic drugs modify PAK signaling pathways, and provide insight regarding modulation of these pathways to potentially reduce diabetes-associated cancer risk. Methods: PAK interacting partners in T2DM were identified using online STRING database. Correlation studies were performed via systematic literature review to understand the effect of anti-diabetic drugs on PAK signaling. Mini meta analysis correlated multiple clinical studies and revealed the overall clinical response rate and percentage of adverse events in piogliazone (n=53) and metformin (n=91) treated patients with PAK-associated diseases. Results: A total of 30 PAK interacting partners were identified (10: reduced beta-cell mass; 10: beta-cell dysfunction; 10: obesity-insulin resistance) which were highly associated with Wnt, and G-protein signaling. Anti-diabetic drug metformin activated signaling pathways upstream; whereas pioglitazone inhibited pathways downstream of PAK. Overall clinical response upon pioglitazone treatment was 53%. 79% of pioglitazone and 75% of metformin treated patients had adverse events. Pioglitazone reduced molecular-PAK biomarkers of proliferation (Ki67 and CyclinD1), and metformin had the opposite effect. Conclusions: PAK signaling in T2DM likely involves Wnt and G-protein signaling which may be altered by anti-diabetic drugs metformin and pioglitazone. Apart from the therapeutic limitations of adverse events, pioglitazone may be promising in chemoprevention, however long-term multi-centered studies, which initiate pioglitazone treatment early will be required to fully assess the full potential of these drugs.

Preprint ARTICLE | doi:10.20944/preprints201912.0213.v1

Association of Short Stature with An Increased Risk of End-Stage Renal Disease in Type 2 Diabetic Patients: A Nationwide Population-Based Cohort Study

Yu Ah Hong, Kyung-Do Han, Jae-Seung Yun, Eun Sil Koh, Seung-Hyun Ko, Sungjin Chung

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: short stature; type 2 diabetes; end-stage renal disease; mortality

Online: 16 December 2019 (11:12:15 CET)

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Preprint ARTICLE | doi:10.20944/preprints202211.0121.v1

Post-COVID Endocrine Disorders: Putative Role of Molecular Mimicry and Some Pathomorphological Correlates

Muslimbek Ghulomovich Normatov, Vadim Evgenievich Karev, Andrey Victorovich Kolobov, Vera Arkad'yevna Mayevskaya, Varvara Aleksandrovna Ryabkova, Vladimir Josefovich Utekhin, Leonid Pavlovich Churilov

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Antigen mimicry; Autoimmune diseases; SARS-CoV-2; Human Coronaviruses; Thyroid gland; Pancreatic islets; Adrenals; Pituitary

Online: 7 November 2022 (11:32:33 CET)

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Working Paper ARTICLE

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study

Masliza Hanuni Mat Ali, Najib Majdi Yaacob, Norhayati Yahaya, Nani Draman, Wan Mohd Izani Wan Mohamed, Mohd Shafie Abdullah, Wan Norlina Wan Azman, Hanim Afzan Ibrahim, Wan Nor Fazila Hafizan Wan Nik, Mafauzy Mohamed, Tuan Salwani Tuan Ismail

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Hyperthyroid; Hypothyroid; Euthyroid; Vitamin D; Bone Turn Over Markers; Bone Mineral Density

Online: 23 September 2020 (04:52:34 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202004.0463.v1

Serum Cytokine Dependent Hematopoietic Cell Linker (CLNK) as a Predictor for the Duration of Illness in Type 2 Diabetes Mellitus

Suhaer Zeki Al-Fadhel, Nibras H. Abdulsada Al-Ghuraibawi, Dunia M. Mohammed Ali, Hussein Kadhem Al-Hakeim

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetes mellitus; insulin resistance; cytokines; adaptor proteins; CLNK

Online: 25 April 2020 (11:32:48 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202211.0159.v1

The Effect of Wound Treatment Using Honey on Colonization of Staphylococcus Aureus Bacteria in Diabetic Wounds in Patients with Diabetes Mellitus in the Work Area Banjarmasin Health Center

Novia Ardila, Rizky Maharani, Amalia Sabella, Candra Kusuma Negara

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: care wound; wound diabetic; honey; staphylococcus aureus

Online: 9 November 2022 (01:07:32 CET)

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Preprint ARTICLE | doi:10.20944/preprints202112.0041.v1

Genetics of Vascular Inflammation in Lower Limb Ischemia: The TNF-α Hypothesis in Peripheral Arterial Disease

Diego Caicedo, Clara V. Álvarez, Sihara Pérez, Jesús Devesa

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Vascular inflammation; Peripheral arterial disease (PAD); Chronic limb-threatening ischemia (CLTI); GHAS trial; TNF-α; hs-CRP; Neutrophil-to-lymphocyte ratio (NLR); NOX4; eNOS; VEGF-A.

Online: 3 December 2021 (09:44:42 CET)

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Preprint REVIEW | doi:10.20944/preprints202111.0300.v1

Environmental Contaminants Acting as Endocrine Disruptors Modulate Atherogenic Processes: New Risk Factors for Cardiovascular Diseases in Women?

Silvia Migliaccio, Viviana M Bimonte, Zein Mersini Besharat, Claudia Sabato, Clara Crescioli, Andrea Lenzi, Elisabetta Ferretti

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Endocrine disruptors; gender; female; atherosclerosis; Cadmium; Bisphenol A; inflammatory cytokines; cardiovascular diseases

Online: 17 November 2021 (10:53:12 CET)

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Preprint ARTICLE | doi:10.20944/preprints202007.0552.v1

Delving Deep into the Structural Aspects of the BPro28-BLys29 Exchange in Insulin Lispro: A Structural Biophysical Lesson

Wei Li

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Insulin lispro; BPro28-BLys29 Exchange; Interfacial biophysics; Structural analysis;

Online: 23 July 2020 (11:45:01 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202106.0364.v2

Sonication of Kirschner Wire as a Tool for the Microbiological Diagnosis of Diabetic Foot Infection

Rodrigo Cuiabano Paes Leme, Jéssica Reis Esteves Chaves, Luiz Carlos Soares Gonçalves, Leonardo César Alvim, João Roberto Chaves de Almeida, Leonardo da Cruz Renó

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetic foot infection; Sonication Method; Microbiological diagnosis.

Online: 24 November 2021 (11:51:36 CET)

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Preprint ARTICLE | doi:10.20944/preprints202211.0474.v1

Combining Semi-targeted Metabolomics and Machine Learning to Identify Metabolic Alterations in Serum and Urine of Hospitalized Patients with COVID-19

Gerard Baiges-Gaya, Simona Iftimie, Helena Castañé, Elisabet Rodríguez-Tomàs, Andrea Jiménez-Franco, Ana F. López-Azcona, Antoni Castro, Jordi Camps, Jorge Joven

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Keywords: biomarkers; COVID-19; machine learning; metabolomics; SARS-CoV-2.

Online: 25 November 2022 (08:05:52 CET)

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Preprint ARTICLE | doi:10.20944/preprints202308.1754.v1

DiabeticSense: A Non-Invasive Multi-Sensor IoT-based System for Diabetes Detection Using Breath

Ritu Kapur, Yashwant Kumar, Swati Sharma, Vedant Rastogi, Shivani Sharma, Vikrant Kanwar, Tarun Sharma, Varun Dutt

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: digital health devices; diabetes test; bio-markers; blood glucose monitoring; diabetes; exhaled breath analysis; non-invasive; volatile organic compounds

Online: 25 August 2023 (08:29:07 CEST)

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Preprint REVIEW | doi:10.20944/preprints202301.0515.v2

The Double-edged Sword of Antioxidant Supplements on Metabolic Diseases, A Necessity for Quantification of Oxidative Status

Wei-Zheng Zhang

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: antioxidant supplements; ROS; oxidative stress analysis; metabolic diseases

Online: 30 January 2023 (02:46:04 CET)

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Preprint ARTICLE | doi:10.20944/preprints202112.0415.v1

Multicenter Retro-Prospective Observational Study on Chronic Hypoparathyroidism and rhPTH (1-84) Treatment

Gemma Marcucci, Guglielmo Beccuti, Giulia Carosi, Filomena Cetani, Luisella Cianferotti, Anna Maria Colao, Carolina Di Somma, Mirko Duradoni, Antonia Elefante, Lucia Ghizzoni, Massimo Giusti, Andrea Gerardo Lania, Elisabetta Lavezzi, Bruno Madeo, Giovanna Mantovani, Claudio Marcocci, Laura Masi, Simone Parri, Francesca Pigliaru, Assunta Santonati, Antonio Spada, Lara Vera, Maria Luisa Brandi

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Chronic Hypoparathyroidism; rhPTH (1-84); Natpar®; Treatment

Online: 24 December 2021 (23:55:38 CET)

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Preprint REVIEW | doi:10.20944/preprints202209.0165.v1

Digital Biomarkers of Poor Gait and Balance in Diabetic Foot, Measurable by Wearables: A Review of Literature

Gu Eon Kang, Angeloh Stout, Ke’Vaughn Waldon, Seungmin Kang, Amanda L. Killeen, Peter A. Crisologo, Michael Siah, Daniel Jupiter, Bijan Najafi, Ashkan Vaziri, Lawrence A. Lavery

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetic foot; Diabetic neuropathies; Peripheral arterial disease; Foot ulcer; Gait; Walking; Postural balance; Wearable electronic devices; Gait analysis; Digital technology

Online: 13 September 2022 (09:28:22 CEST)

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Preprint REVIEW | doi:10.20944/preprints202402.1579.v1

Overview of Ethnobotanical-Pharmacological Studies carried out on Medicinal Plants from the Serra da Estrela Natural Park

Radhia Aitfella Lahlou, Filomena Carvalho, Maria João Pereira, João Lopes, Luís R. Silva

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Natural Park of Serra da Estrela; Botanical diversity; Medicinal plants; Diabetes prevention and treatment; Pharmacological applications; chemical composition.

Online: 27 February 2024 (16:02:34 CET)

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Preprint REVIEW | doi:10.20944/preprints202308.1440.v1

Safeguarding Intimate Health: Decoding the Interplay of Diabetes and Erectile Dysfunction

Shamima Akter, Mayank Choubey, Shahida Arbee, Mohammad Mohabbulla Mohib, Munichandra B. Tirumalasetty, Naofel Minhaz, Mohammad Sarif Mohiuddin

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetes; Erectile dysfunction; microvascular complications; diabetic sexual health; men’s sexual health

Online: 21 August 2023 (08:21:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202311.0063.v1

Essential Oil Components May Act as Antiandrogen Compounds in Prostate Cancer by Inhibition of Steroidogenic Cytochrome P450 Activities

Katyayani Sharma, Angelo Lanzilotto, Jibira Yakubu, Søren Therkelsen, Clarissa Daniela Voegel, Therina Du Toit, Flemming Steen Jørgensen, Amit V. Pandey

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: EDCs; Prostate cancer; CYP17A1; steroidogenesis; DHEA; anti cancer drugs

Online: 1 November 2023 (10:12:15 CET)

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Endocrine-disrupting chemicals (EDCs) may impact the development of Prostate Cancer (PCa) by altering the steroid metabolism. Although their exact mechanism of action in controlling tumor growth is not known, EDCs may inhibit steroidogenic enzymes such as Cytochrome P450 c17 (CYP17A1) or aromatase (CYP19A1) involved in the production of Androgens or Estrogens. High levels of circulating androgens are linked to PCa in men and Polycystic Ovary Syndrome (PCOS) in women. Essential Oils or their metabolites (EOs) like lavender oil and tea tree oil have been reported to act as potential EDCs and contribute towards sex steroid imbalance in case of prepubertal gynecomastia in boys and premature thelarche in girls due to the regular exposure to lavenderbased fragrances among Hispanic population. We screened a range of EO components to determine their effects on CYP17A1 and CYP19A1 Computational docking was performed to predict the binding of EOs with CYP17A1 and CYP19A1 and functional assays were done using the radiolabeled substrates or Liquid Chromatography high-resolution Mass Spectrometry and cell viability assays were carried out in LNCaP cells. Many of the tested compounds bind close to the active site of CYP17A1, and (+)-Cedrol had the best binding with CYP17A1 and CYP19A1. Eucalyptol, Dihydro-β-Ionone & (-)-α-pinene showed 20% to 40% inhibition of dehydroepiandrosterone production; and some compounds also effected CYP19A1. Extensive use of these EOs in various beauty and hygiene products is common, but only a limited knowledge about their potential detrimental side effects exists. Our results suggest that prolonged exposure to some of these essential oils may result in steroid imbalances. On the other hand, due to their effect on lowering androgen output, ability to bind at the active site of steroidogenic cytochrome P450s, these compounds may provide design ideas for the novel compounds against hyperandrogenic disorders such as PCa and PCOS.

Preprint ARTICLE | doi:10.20944/preprints202310.1192.v1

Selective roles of Interleukin-10 Family Members (IL-10, IL-19, IL-22) and Varying Levels of Obesity in the Pathogenesis of Type 2 Diabetes in Patients from Asir Region of Saudi Arabia

Mohammad Muzaffar Mir, Jaber Alfaifi, Shahzada Khalid Sohail, Syeda Fatima Rizvi, Mushabab A. Alghamdi, Rashid Mir, Javed Iqbal Wani, Zia UL Sabah, Fahad A. Alhumaydhi, Fahad Alremthi, AbdulElah Al Jarallah AlQahtani, Muffarah Hamid Alharthi, Masoud Ishag, Imadeldin Elfaki, Hany M. A. Sonpol

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetes; Pro and anti-inflammatory cytokines; T2DM in Saudi Arabia; Pathogenesis; IL-10; IL-19; and IL 22; Obesity

Online: 18 October 2023 (13:47:02 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202309.0105.v1

Aging Exacerbates Oxidative Stress and Liver Fibrosis in an Ani-Mal Model of Down Syndrome

Sebastiano Giallongo, Veronika Talianova, Emanuela Tropea, Jessica Ferrigno, Rosario Caltabiano, Giuseppe Broggi, Alfio Distefano, Amer Alanazi, Antonella Tramutola, Marzia Perluigi, Eugenio Barone, Ignazio Barbagallo

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: down syndrome; oxidative stress; liver; aging

Online: 4 September 2023 (03:50:26 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202302.0519.v1

The Effect on HbA1c Levels of Age and Gender in Adults Without Diabetes Mellitus

Gülşen Şener, Esra Deniz Kahvecioğlu, Başak Can, Alper Gümüş, Semih Beyazıt Yeşil, Betül Evran

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetes mellitus; HbA1c; gender; age; correlation

Online: 28 February 2023 (10:39:45 CET)

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Preprint REVIEW | doi:10.20944/preprints202312.1358.v1

Moody Only Monogenic? A Narrative Review of the Rare and Low-Penetrant Genetic Variants

Iderina Hasballa, Davide Maggi

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: maturity-onset diabetes of the young; MODY; monogenic diabetes; diabetes mellitus

Online: 19 December 2023 (09:47:23 CET)

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Introduction: Maturity-onset diabetes of the young (MODY) represents the most frequent form of monogenic diabetes mellitus (DM), currently classified in 14 distinct subtypes according to single gene mutations involved in the differentiation and function of pancreatic β-cells. Case report: The female patient at the age of 16 years old was diagnosed with non-autoimmune DM with glycated haemoglobin (HbA1c) value of 6.5%. After 6 years of dietary and lifestyle interventions due to the worsening of the glycometabolic profile, oral hypoglicemic therapy was initiated including at first only metformin, and subsequently also sulfonylureas and DPP-IV inhibitor. 11 years after diagnosis glargine insulin was started, associated 3 years later with Lispro insulin because of the worsening of the post-prandial glycaemia. According to the genetic testing a compound heterozygosis of two novel variants of uncertain/unknown clinical significance of BLK and RFX6 genes, respectively c.1013T>C (Ile338Thr) and c.1072G>A (Val358Ile), was identified. The RFX6 variant was also detected in the patient’s mother genome, while the BLK variant in her father’s. Discussion: Up to 11% of MODY has unknown etiology, suggesting that the genetic landscape is still to be explored. Recently, novel causal genes, involved in the differentiation and function of β-cells, have been identified such as RFX6, NKX2.2, NKX6.1, WFS1 and PCBD1. Genetic and clinical features of MODY variants remain highly heterogeneous, with no direct genotype-phenotype correlation especially in the low-penetrant subtypes. Thus, the aim of our paper is to present additionally to such rare case of a compound heterozygosity BLK/RFX6 underlying MODY, also a brief review of literature focused on the rare and reduced-penetrant variants, as well as on some controversies regarding this subtype of monogenic diabetes. Conclusions: Due to the limited data available, the assessment of MODY related-genes pathogenicity remains challenging especially in the setting of rare and low-penetrant subtypes. In consideration of the crucial importance of an accurate diagnosis, prognosis and management of MODY, more studies are warranted to further investigate its genetic landscape, the genotype-phenotype correlation, as well as the pathogenetic contribution of the non-genetic modifiers in this cohort of patients.

Preprint ARTICLE | doi:10.20944/preprints202309.0172.v1

Thromboembolic Events after COVID-19 Vaccination: An Italian Retrospective Real-World Safety Study

Francesca furtura Bernardi, Annamaria Mascolo, Marina Sarno, Nicolina Capoluongo, Ugo Trama, Rosanna Ruggiero, Liberata Sportiello, Giovanni Maria Fusco, Massimo Bisogno, Enrico Coscioni, Pierpaolo Di micco, Annalisa Capuano, Alessandro Perrella

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: COVID-19; vaccination; mRNA vaccine; thrombotic events

Online: 5 September 2023 (03:55:17 CEST)

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Introduction: Real-world safety studies can provide important evidence on the thromboembolic risk associated with COVID-19 vaccines, considering that millions of people have been already vaccinated against COVID-19. In this study, we aimed to estimate the incidence of thromboembolic events after COVID-19 vaccination and to compare the Oxford–AstraZeneca vaccine with other COVID-19 vaccines. Methods: We conducted a retrospective real-world safety study using data from two different data sources: the Italian Pharmacovigilance database (Rete Nazionale di Farmacovigilanza, RNF) and the Campania Region Health system (Sistema INFOrmativo saNità CampanIA, SINFONIA). From the start date of the COVID-19 vaccination campaign (December 27th, 2021) to September 27th, 2022, information on COVID-19 vaccinations and thromboembolic evets were extracted from the two databases. The reporting rate (RR) and its 95% confidence interval (95%CI) of thromboembolic events for 10,000 doses was calculated for each COVID-19 vaccine. Moreover, the odds of being vaccinated with the Oxford–AstraZeneca vaccine vs. the other COVID-19 vaccines in cases with thromboembolic events vs. controls without thromboembolic events were computed. Results: A total of 12,692,852 vaccine doses were administered in Campania Region, of which 6,509,475 (51.28%) were in female and mostly related to the Pfizer-BioNtech vaccine (65.05%), followed by Moderna (24.31%), Oxford–AstraZeneca (9.71%), Janssen (0.91%), and Novavax (0.02%) vaccines. A total of 641 ICSRs with a COVID-19 vaccines and a vascular events were retrieved from the RNF for the Campania Region, of which 453 (70.67%) were in female. Most ICSRs reported the Pfizer-BioNtech vaccine (65.05%), followed by Oxford–AstraZeneca (9.71%), Moderna (24.31%), and Janssen (0.91%). A total of 2,451 events were reported in the ICSRs (3.8 events for ICSRs) of which 292 were thromboembolic events. The highe RRs of thromboembolic events were found with the Oxford–AstraZeneca vaccine (RR: 4.62, 95%CI: 3.50-5.99) and Janssen vaccine (RR: 3.45, 95%CI: 0.94-8.82). Thromboembolic events were associated with a higher likelihood of exposure to the Oxford–AstraZeneca vaccine compared to Pfizer-BioNtech (OR: 6.06; 95%CI: 4.22-8.68) and Moderna vaccines (OR: 6.46; 95%CI: 4.00-10.80). Conclusion: We observed a higher reporting of thromboembolic events with viral-vector based vaccines (Oxford–AstraZeneca and Janssen) and an increased likelihood of being exposed to the Oxford–AstraZeneca vaccine compared to the mRNA vaccines (Pfizer-BioNtech and Moderna) among thromboembolic cases.

Preprint REVIEW | doi:10.20944/preprints202305.1431.v1

Changes in Cortisol Secretion and Corticosteroid Receptors in Critically Ill Patients with Sepsis/Septic Shock and Scope for Treatment

Ioannis Ilias, Alice G. Vassiliou, Chrysi Keskinidou, Charikleia S. Vrettou, Stylianos Orfanos, Anastasia Kotanidou, Ioanna Dimopoulou

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: CIRCI; sepsis; critical illness; adrenal; cortisol; glucocorticoid receptor

Online: 19 May 2023 (10:32:24 CEST)

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Sepsis is associated with dysregulated cortisol secretion, leading to abnormal levels of cortisol in the blood. In the early stages of sepsis, cortisol levels are typically elevated due to increased secretion from the adrenal glands. However, as the disease progresses, cortisol levels may decline due to impaired adrenal function, leading to relative adrenal insufficiency. The latter is thought to be caused by a combination of factors, including impaired adrenal function, decreased production of corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) by the hypothalamus and pituitary gland, and increased breakdown of cortisol by enzymes such as 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). The dysregulation of cortisol secretion in sepsis is thought to contribute to the pathophysiology of the disease by impairing the body's ability to mount an appropriate inflammatory response. The actions of cortisol are mediated through two types of corticosteroid receptors: the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GCR). In sepsis, the expression and activity of GCR is altered, contributing to the pathophysiology of the disease. GCR expression and activity are typically downregulated in sepsis, impairing the body's ability to mount an appropriate inflammatory response. Given the dysregulation of cortisol secretion and corticosteroid receptors in sepsis, there has been considerable interest in the use of steroids as a treatment for sepsis. The rationale for steroid-based treatment is to supplement the body's endogenous cortisol production, restore normal cortisol levels, and improve the body's ability to mount an appropriate inflammatory response. However, the use of steroids in sepsis remains controversial, and clinical trials have yielded mixed results. Some studies have shown that steroid-based treatment can improve shock reversal, reduce the need for vasopressors, and improve overall survival in patients with septic shock, whereas other studies have found no benefit or even harm from steroid-based treatment in sepsis.

Preprint REVIEW | doi:10.20944/preprints202404.0380.v1

Obesogens in Adolescence. Challenging Aspects and Prevention Strategies.

Marina Nicolaou, Meropi Toumba, Alexandros Kythreotis, Habib Daher, Nicos Skordis

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: endocrine disrupting chemicals; obesogens; obesity; children; adolescents; prevention strategies

Online: 5 April 2024 (06:51:44 CEST)

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Preprint REVIEW | doi:10.20944/preprints202308.2062.v1

Understanding Proteinuria in Patients with Diabetic Kidney Disease and Progress of Drug Therapy from a New Perspective

Ruimin Zhang, Qian Wang, Xuefeng Zhou, Qihu Li, Zheyi Dong, Xiangmei Chen

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: diabetic kidney disease; proteinuria; pathophysiological mechanism; drug therapy

Online: 31 August 2023 (03:22:20 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202311.0522.v1

A Novel Mutation in the INSR Causes Severe Insulin Resistance and Rabson-Mendenhall Syndrome in a Paraguayan Patient

Maria Natalia Rojas Velazquez, Fabiola Blanco, Ana Ayala-Lugo, Lady Franco, Valerie Jolly, Denisse Di Torre, Idoia Martínez De Lapiscina, Marco Janner, Christa E Flück, Amit V. Pandey

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Rabson-Mendenhall syndrome; insulin resistance; diabetes mellitus; acanthosis nigricans; tyrosine kinase; insulin; Insulin receptor; INSR

Online: 8 November 2023 (07:35:08 CET)

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Preprint ARTICLE | doi:10.20944/preprints202311.1958.v1

Induction of Oxidative Stress and Ferroptosis in Triple-Negative Breast Cancer Cells by Niclosamide via Blockade of the Function and Expression of SLC38A5 and SLC7A11

Marilyn Mathew, Sathish Sivaprakasam, Gunadharini Dharmalingam-Nandagopal, Souad R. Sennoune, Nhi T. Nguyen, Valeria Jaramillo-Martinez, Yangzom D. Bhutia, Vadivel Ganapathy

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: SLC38A5; SLC7A11; TNBC cells; seleno-methionine; glutathione; glutathione peroxidase; Nrf2; ferroptosis; lipid peroxidation; niclosamide

Online: 30 November 2023 (10:44:16 CET)

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Preprint ARTICLE | doi:10.20944/preprints202304.0930.v1

Economic Impact of the Implementation of a Multidisciplinary Diabetic Foot Clinic in a Tertiary Hospital

Alejandra Pérez-Montes, Laura Ricou Ríos, Arnau Pons Calsapeu, Francesc López Seguí, Clàudia Riera, Marc Sirvent, Esteban Reynaga, Jordi Viadé, Paloma Malagon, Berta Soldevila, Ricard Perez, Elena Casademunt, Glòria Bonet, Manel Puig Domingo, Oriol Estrada, Núria Alonso

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Multidisciplinary pain clinic; Diabetic foot; Amputation; Foot ulcer; Diabetes Mellitus; Economic evaluation; Cost Benefit Analysis

Online: 26 April 2023 (02:45:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202211.0167.v1

Impact of Japan’s State of Emergency on Trends in Diabetes Care during the COVID-19 Pandemic: A Retrospective and Descriptive Study

Akira Minoura, Kouzou Murakami, Masaaki Matoba, Yoshinori Ito, Yumi Kamijo, Akatsuki Kokaze

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: COVID-19 pandemic; diabetes care; infection control; Japanese; state of emergency

Online: 9 November 2022 (02:18:40 CET)

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Preprint REVIEW | doi:10.20944/preprints202306.1909.v1

Diabetic Ketoacidosis in Children and Adolescents; Diagnostic and Therapeutic Pitfalls

Eirini Kostopoulou, Xenophon Sinopidis, Sotirios Fouzas, Despoina Gkentzi, Theodore Dassios, Stylianos Roupakias, Gabriel Dimitriou

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Diabetic ketoacidosis; type 1 diabetes mellitus; pitfalls; children; diagnosis; management

Online: 27 June 2023 (12:51:47 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202208.0551.v1

Methylprednisolone Induced Lymphocytosis: A Prospective Study in 20 Ppatients with Immune Mediated Inflammatory Disorders

Camille Beniada, Bruno Couturier, Florence Reye, Cedric Delporte, Pierre Van Antwerpen, Viviane De Maertelaer, Elie Cogan

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Glucocorticoids; lymphocytosis; methylprednisolone; beta-blockers; adrenergic tone; IMID

Online: 31 August 2022 (16:25:28 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202309.2148.v1

Reactive Hypoglycemia: A Trigger for Nutrient-Induced Endocrine and Metabolic Responses in Polycystic Ovary Syndrome

Sidika E. Karakas

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: reactive hypoglycemia; postprandial hypoglycemia; polycystic ovary syndrome; protein supplements; whey protein; weight loss; adrenal steroids; ghrelin

Online: 30 September 2023 (08:09:53 CEST)

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Preprint REVIEW | doi:10.20944/preprints202308.1155.v1

Insulin Therapy among Diabetic Patients in Rural Communities of Sub Saharan Africa: A Perspective Review

Ritah Kiconco, Sylvia Acheng Lumumba, Charles Bagenda, Raymond Atwine, Joseph Ndarubwine, Simon Peter Rugera

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Insulin; Glucagon; hypoglycaemia; hyperglycaemia; glycated hemoglobin; oral hypoglycaemics

Online: 16 August 2023 (09:34:53 CEST)

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Preprint REVIEW | doi:10.20944/preprints202306.1623.v1

The Usefulness of Thyroid Antibodies in the Diagnostic Approach to Autoimmune Thyroid Disease

Hernando Vargas-Uricoechea, Juan Patricio Nogueira, María V. Pinzón-Fernández, Diego Schwarzstein

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Thyroid; autoimmunity; antibodies; thyrotropin; receptor; thyroglobulin; peroxidase

Online: 22 June 2023 (12:25:56 CEST)

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Preprint REVIEW | doi:10.20944/preprints202308.1106.v1

Environmental Endocrinology: Parabens Hazardous Effects on HPT Axis

Damáris Barcelos Cunha Azeredo, Denilson de Sousa Anselmo, Paula Soares, Jones Bernardes Graceli, D'Angelo Carlo Magliano

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: parabens; toxicity; thyroid; HPT axis; TSH; TH; hormone

Online: 15 August 2023 (07:47:57 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202302.0296.v1

High Fructose Causes More Prominent Liver Steatohepatitis With Leaky Gut Similar to High Glucose Administration in Mice and Attenuation by Lactiplantibacillus plantarum dfa1

Thunnicha Ondee, Krit Pongpirul, Kanyarat Udompornpitak, Warumphon Sukkummee, Thanapat Lertmongkolaksorn, Sayamon Senaprom, Asada Leelahavanichkul

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Glucose; Fructose; Obesity; Prediabetes; Lactiplantibacillus plantarum

Online: 17 February 2023 (06:16:55 CET)

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High-sugar diet-induced prediabetes and obesity is a current worldwide important problem that can be the result of glucose or fructose. However, a head-to-head comparison between both sugars on health impact is still less and Lactiplantibacillus plantarum dfa1 has never been tested and recently isolated from healthy volunteers. The mice with high-sugar diet-induced prediabetes and in vitro experiments were then performed. After 12 weeks of experiments, both glucose and fructose induced a similar severity of obesity (weight gain, lipid profiles and fat deposition at several sites) and prediabetes condition (fasting glucose, insulin, oral glucose tolerance test, and Homeostatic Model Assessment for Insulin Resistance (HOMA score)). However, fructose administration induced more severe liver damage (serum alanine transaminase, liver weight, histology score, fat components, and oxidative stress) than the glucose group, while glucose caused more prominent intestinal permeability damage (FITC-dextran assay) and serum cytokines (TNF-α, IL-6, and IL-10) compared to the fructose group. Interestingly, all these parameters were attenuated by L. plantarum dfa1 administration. Because there was a subtle change in the fecal microbiome analysis of mice with glucose or fructose administration compared to control mice, probiotics altered only some microbiome parameters (Chao1 and Lactobacilli abundance). For in vitro experiments, glucose induced more damage to high-dose lipopolysaccharide (LPS) (1 µg/mL) to enterocytes (Caco2 cell) than fructose, as indicated by transepithelial electrical resistance (TEER), supernatant cytokines (TNF-α and IL-8), and glycolysis capacity (by extracellular flux analysis). Meanwhile, both glucose and fructose similarly facilitated LPS injury in hepatocytes (HepG2 cell) as evaluated by supernatant cytokines (TNF-α, IL-6, and IL-10) and extracellular flux analysis. In conclusion, glucose possibly induced a more severe intestinal injury (perhaps due to LPS-glucose synergy) and fructose caused a more prominent liver injury (possibly due to liver fructose metabolism), despite a similar effect on obesity and prediabetes. Prevention of obesity and prediabetes with probiotics was encouraged.

Preprint CASE REPORT | doi:10.20944/preprints202309.0141.v1

Thyroid Eye Disease as Initial Manifestation of Graves’ Disease Following Viral Vector SARS-CoV-2 Vaccine—Report of A Case and Review of the Literature

Anastasia K Armeni, Georgios K Markantes, Alexandra Stathopoulou, Katerina Saltiki, Petros Zampakis, Stelios F Assimakopoulos, Marina A Michalaki

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: Thyroid eye disease; Graves’ disease; viral vector SARS-CoV-2 vaccine; ChAdox1nCoV-19; COVID-19

Online: 5 September 2023 (03:32:09 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0562.v1

Glucose Levels of the Oral Glucose Tolerance Test (oGTT) Can Predict Adverse Pregnancy Outcomes in Women with Gestational Diabetes (GDM)

Selina Balke, Petra Weid, Laura Fangmann, Paul Rostin, Wolfgang Henrich, Josefine Theresia Koenigbauer

Subject: Medicine And Pharmacology, Endocrinology And Metabolism Keywords: oGTT, oral glucose tolerance test, gestational diabetes, GDM, cesarean section

Online: 19 April 2023 (07:38:14 CEST)

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Objectives and Background: Gestational diabetes (GDM) is a common pregnancy complication, defined as a glucose intolerance diagnosis during pregnancy. GDM is strongly associated with adverse fetal and maternal outcomes. In Germany, to screen and diagnose GDM we use a 1-hour 50g oGCT (oral glucose challenge test) followed by a 2-hour 75g oGTT if the first was pathological. This analysis examines the correlation of 75g oGTT glucose levels and fetomaternal outcome. Methods: Data of 1664 patients from a gestational diabetes consultation clinic at the Charité University hospital in Berlin, Germany, were analyzed retrospectively from 2015 until 2022. The 75g oGTT blood glucose levels were categorized into isolated fasting hyperglycemia (GDM-IFH), isolated post-load hyperglycemia (GDM-IPH) and combined hyperglycemia (GDM-CH), using the levels of the fasting, 1-hour and 2-hour values after glucose application. These subtypes were compared regarding baseline characteristics as well as fetal and maternal outcome. Results: GDM-IFH and GDM-CH women displayed higher preconceptional BMI and required insulin therapy more frequently (p<0,001). The GDM-IFH group was at higher risk of having a primary cesarean section (p=0,047), while GDM-IPH women were significantly more likely to have an emergent cesarean section (p=0,013). The offspring of GDM-IFH and GDM-CH women were born with a significantly higher mean birthweight (p<0,001) and birth weight percentiles (p<0,001) and were at increased risk of being large for gestational age (LGA) (p=0,004). Women from the GDM-IPH group delivered significantly more neonates who were small for gestational age (p=0,027) or with low fetal weight <30th percentile (p=0,003). Conclusion: This analysis shows a strong association between glucose response pattern in the 75g oGTT and adverse perinatal fetomaternal outcome. The differences among the subgroups, specifically concerning insulin therapy, mode of delivery and fetal growth, suggest an individualized approach in prenatal care after a GDM diagnosis.

Medicine and Pharmacology