Special Issues

Pathogenesis, Treatment and Complications of Diabetes Mellitus
Editor: Gulali Aktas

Submission Deadline: 30 November 2023 (Status: Open)

Special Issue Editor(s)

Gulali Aktas      Email   |   Website
Abant Izzet Baysal University, Bolu, Turkey
Interests: Type 2 diabetes mellitus; inflammation; metabolic syndrome; obesity; fatty liver disease; diabetic kidney disease; diabetic neuropathy; hypertension; frailty; nutrition

Special Issue Information

Dear Colleagues,

Diabetes Mellitus is one of the most common metabolic diseases in the world. Despite the recent increase in diabetes prevention programs, the prevalence of Type 2 diabetes mellitus is increasing at an alarming rate. Both diabetes mellitus itself and its complications are harmful to patients. In addition, patients with diabetes require more costly health insurance. Both diabetes itself and its complications impose a great burden on healthcare systems. Hence, timely diagnosis and effective treatments are mandatory to prevent serious long-term adverse events related to diabetes mellitus. Effective diagnosis and treatment strategies are based on a better understanding of the pathogenesis of the disease itself and its complications.

Research focusing on the pathogenesis of type 2 diabetes mellitus is encouraged. Moreover, studies on both effective treatment strategies for diabetes and on measures which either detect earlier or fully prevent its complications are needed. Treatment choices with maximum efficacy with minimum side effects are welcome in treatment of diabetes mellitus. Though lifestyle changes including altered diet and exercise patterns are currently established first, most patients require additional measures. Treatments with oral hypoglycemic drugs and parenteral glucagon like peptide-1 analogs or insulin are becoming more common. In recent years, surgical procedures such as sleeve gastrectomy, have been implemented for morbidly obese patients with Type 2 diabetes mellitus. Hypoglycemia and other acute complications of diabetes can be minimized with early diagnosis, effective treatment and increased awareness of patients or caregivers. Chronic complications, such as diabetic nephropathy, neuropathy, retinopathy, foot ulcers and macrovascular complications can be avoided or delayed through careful glycemic control.

Novel approaches to diagnosis, treatment strategies, and prevention and early detection methods of complications are required for effective care of the diabetic population. Therefore, reviews or original research papers which aim to achieve a better understanding of the pathogenesis of Type 2 diabetes and its complications, treatment choices and their efficacy, and prevention, timely diagnosis and management of diabetic complications are invited for this special issue.

Waiting eagerly for you valuable contribution.

Gulali Aktas
Guest Editor


diabetes mellitus; pathogenesis; diagnosis; treatment; diabetic kidney disease; diabetic retinopathy; diabetic neuropathy; diabetic foot ulcer; macrovascular diabetic complications; hypoglycemia

Manuscript Submission Information

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  • Article
    Aziz Sener, Selin Yildiz, Gulce Kiren, Canan Topcuoglu
    Journal of Biological Regulators and Homeostatic Agents. 2023, 37(11): 6005-6013. https://doi.org/10.23812/j.biol.regul.homeost.agents.20233711.575
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    Background: Recently, new inflammatory parameters obtained from complete blood count and biochemical measurements have gained importance. They are easy and inexpensive to perform. These parameters have been shown to have relationships with glycemic control and complications in diabetic patients in various studies. We aimed to compare new inflammatory markers [neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), monocyte to lymphocyte ratio (MLR), monocyte to high-density lipoprotein ratio (MHR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV)] among well-controlled and poorly controlled diabetic patient groups and also between albuminuria groups in Type 2 Diabetes Mellitus (T2DM) patients.

    Methods: We included 415 T2DM patients and analyzed them retrospectively. We divided the patients into well-controlled diabetics (hemoglobin A1C (HbA1c) ≤7%) and poorly-controlled diabetics (HbA1c >7%) to evaluate diabetic control. We also grouped patients in order to evaluate albuminuria as follows: A1: urine albumin-creatinine ratio (UACR) <30 mg/g, A2: 30 mg/g ≤ UACR ≥ 300 mg/g, A3: UACR >300 mg/g. We compared the groups we formed based on diabetic control and albuminuria levels regarding new inflammatory markers and determined the correlation between these markers and HbA1c and UACR levels.

    Results: MHR showed a more remarkable and noticeable difference than other parameters when comparing A2 and A1 albuminuria group patients. Our study found that MLR was positively correlated with UACR measurements but not superior to other parameters that were positively correlated with UACR (p < 0.01). NLR and PLR differed significantly between the albuminuria groups and were positively correlated with UACR measurements (p < 0.01). RDW, on the other hand, did not show statistical differences between the albuminuria groups but was positively correlated with UACR measurements (p > 0.05, p < 0.01 respectively). MPV, neither statistically differed between the albuminuria groups nor showed correlation with UACR measurements (p > 0.05 for each). There was no difference in the results of new inflammatory markers between diabetes control groups, and there was no correlation with HbA1c measurements (p > 0.05 for each).

    Conclusions: These parameters are useful in assessing albuminuria in patients with T2DM, but not in assessing glycemic control.

  • Article
    Orhan DALKILIC
    Journal of Biological Regulators and Homeostatic Agents. 2023, 37(11): 5955-5959. https://doi.org/10.23812/j.biol.regul.homeost.agents.20233711.570
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    Background: Type 2 diabetes mellitus is associated with an increased risk of certain infections, such as pneumonia. Timely diagnosis and treatment of infections is crucial in populations with diabetes. The C-reactive protein to lymphocyte ratio (CLR) has been proposed as a novel marker of inflammation. We studied the role of CLR in subjects with diabetes who had pneumonia.

    Methods: A total of 426 subjects with pneumonia and type 2 diabetes mellitus who presented to the pulmonology clinics of Hisar Intercontinental Hospital were enrolled in the study, and 161 patients with diabetes who had no pneumonia were enrolled as controls. Overall, 176 (66.4%) of the diabetic pneumonia group and 101 (62.7%) of the control subjects were men. C-reactive protein (CRP) was analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) immune assay, and lymphocytes were counted by an automatic analyzer. The CLR levels of patients with diabetes comorbid with pneumonia were compared to those diabetics without pneumonia in the present cross-sectional study.

    Results: Median CLR levels of the patients with diabetes comorbid with pneumonia and control subjects were 28.7 (1.1–116)% and 1.9 (0.04–12.2)%, respectively (p < 0.001). The CLR of the participants was significantly and positively correlated with their white blood cell count (r = 0.21, p < 0.001) and serum creatinine levels (r = 0.2, p < 0.001). Receiver operating characteristic (ROC) analysis revealed that CLR (when higher than 5.73%) had 86% sensitivity and 91% specificity in detecting pneumonia in patients with diabetes (AUC (area under the curve): 0.945, p < 0.001, 95% CI (confidence interval): 0.926–0.964). The sensitivity and specificity of CLR was higher than separate values of C-reactive protein (76% sensitivity and 71% specificity when higher than 7.1 mg/L; AUC: 0.813, p < 0.001, 95% CI: 0.774–0.852) and blood leukocyte count (65% sensitivity and 70% specificity when higher than 7.9 k/mm3; AUC: 0.665, p < 0.001, 95% CI: 0.614–0.716).

    Conclusion: These findings suggest that CLR could be a useful marker in the timely diagnosis of pneumonia in populations with diabetes.

  • Article
    Arash Karimi, Pouria Sefidmooye Azar, Mahmoud Reshadatjoo, Mahdi Vajdi, Amir Bahrami, Farzad Najafipour, Helda Tutunchi
    Journal of Biological Regulators and Homeostatic Agents. 2023, 37(9): 4825-4836. https://doi.org/10.23812/j.biol.regul.homeost.agents.20233709.470
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    Background: This study aimed to assess the effects of hydro-alcoholic extract of Fumaria parviflora (FP) on metabolic parameters, anthropometric measures, and serum concentrations of leptin, adiponectin, and resistin in patients with type 2 diabetes mellitus (T2DM).

    Method: Seventy patients with T2DM participated in the present clinical trial. The patients were randomly assigned to one of two groups, receiving either a 500 mg dose of hydro-alcoholic extract of FP or a placebo for 8 weeks. Anthropometric parameters, serum levels of metabolic factors, and serum concentrations of leptin, adiponectin and resistin were assessed pre-and post-intervention. The assessment of dietary intakes was conducted through three-day food records, which were subsequently analyzed via Nutritionist IV software.

    Results: FP treatment significantly led to decreased serum concentrations of fasting blood glucose (p = 0.008), insulin (p = 0.011), triglyceride (p = 0.037), total cholesterol (p = 0.008), low-density lipoprotein cholesterol (p = 0.016), leptin (p = 0.003) and resistin (p = 0.026), and homeostatic model assessment for insulin resistance (HOMA-IR) (p = 0.003). However, there was a statistically significant increase in serum concentrations of high-density lipoprotein cholesterol (HDL-C) (p = 0.019) and adiponectin (p = 0.032), as well as quantitative insulin sensitivity check index (p = 0.014) in the FP group compared to the placebo. No significant differences were observed between the groups for anthropometric indices, hemoglobin A1c (HbA1c), serum levels of liver enzymes, blood urea nitrogen, urea, creatinine, and daily dietary intakes at week eight.

    Conclusion: FP supplementation (500 mg/day) combined with calorie restriction for 8 weeks effectively improved glycemic indices, lipid profile, and serum levels of leptin, resistin and adiponectin in T2DM patients.

    Trial registration: Iranian Registry of Clinical Trials: IRCT20130610013612N11.