简介：AbstractGestational diabetes mellitus (GDM) is a growing public health problem worldwide that threatens both maternal and fetal health. Identifying individuals at high risk for GDM and diabetes after GDM is particularly useful for early intervention and prevention of disease progression. In the last decades, a number of studies have used metabolomics, genomics, and proteomic approaches to investigate associations between biomolecules and GDM progression. These studies clearly demonstrate that various biomarkers reflect pathological changes in GDM. The established markers have potential use as screening and diagnostic tools in GDM and in postpartum diabetes research. In the present review, we summarize recent studies of metabolites, single-nucleotide polymorphisms, microRNAs, and proteins associated with GDM and its transition to postpartum diabetes, with a focus on their predictive value in screening and diagnosis.

简介：Vasopressinistheantidiuretichormoneofhumans.Itisanonapeptidesynthesizedinthemagnocellularneurortsofthesupraopticnucleusofthehypothalamus.Thegeneencodingalargeprecursorprotein,includingvasopressinanditsearrierproteinneurophysin,islocatedonctuvmosome20.q]aelargemoleculeiscleavedasitistransportedintraneumnallytotheposteriorpittfitmy,wherethehormoneanditsneurophysinarestoredbeforetheirreleaseintotilesystemiccirculation,govemedmainlybychangesinbloodosmolalitv.

简介：Pregnancyprofoundlyaffectscarbohydratemetabolism.Thesechangesareimportantinwomenwithdiabetes(typicallytype1,butmoreyoungtype2patientsarebeingencountered)whoareplanningpregnancy,andinwomenwhodevelopgestationaldiabetesmellitus(GDM-glucoseintolerancefirstrecognizedduringpregnancy).Inallcases,acompmherlsiveapproachinvolx4ngexpertiseinobstetrics,diabetology,nursinganddieteticsishighlydesirable.

简介：Theaetiologyandpathogenesisoftype2diabetesremainunclear.Mostpatientsexhibitacombinationoftwomajormetabolicdefects:

简介：Failureofthethyroidglandrequiresthyroidhormonereplacementtherapy,whichisrelativelyeasilyadjustedtoreplicatethenormalphysiologicalstatebymonitoringplasmalevelsofthyroxineand/orthyroid-stimulatinghormone.Incontrast,failureofpancreaticβ-eellsrequiresinsulintherapy,andoptimalreplacementrequiresmonitoring,notoftheabsenthormone(insulin),butofitsmajorsubstmte(glucose).

简介：Erectilefailureisparticularlyconmaoninmenwithdiabetes;itaffectsupto30%,andtheprevalenceincreasesfurtherwithage,durationofdiabetes,andthepresenceofmicrovascularandn'kacrovascularcomplications.Itcanbedistressingforboththemanandhispartner.Thereisnowincreasingawarenessoftheimportanceoftheproblem,andtheincreasedefficacyandavailabilityoftreatmentmakesitcorrectableinmorethan80%of

简介：AbstractBackground:Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.Methods:A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed.Results:In 6204 participants, there are 1002 women (1002/6204, 16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further.Conclusions:The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.

简介：Diabetesmellitus(DM)isachronicsystemicdiseasecharacterizedbyhyperglycemia,withvariouspatho-genicmechanisms.Fromabsoluteorrelativeinsulindeficiency,patientswithDMoftendemonstratevari-ouslevelsofmetabolicdisorders.MajorclinicalmanifestationsofDMincludemetabolicdisorders,vascu-larlesions,circulatorydisturbancesandneurologiccomplications.AlongwithadvancesinDMresearch,re-portsofDMrelatedtinnitusandhearingimpairmenthaveincreasedcontinuously.ResearchonDMrelatedauditorysystemdysfunctionhasfocusedoncochlearmicrocirculation,cellularhomeostasis,geneticsandag-ing.Cochlearmicrocirculationplaysanimportantroleincochlearphysiologyanditsdisordersareassociat-edwithmanyinnereardiseases.Ischemiaandsubsequentreperfusionseenincochlearmicrocirculationdis-ordersareimportantfactorsinhearingdamage.UnderstandingcochlearmicrocirculationandstructuralaswellasfunctionalchangesinDMpatientswithhearinglossandtheircausalfactorswillhelprevealpatho-genicmechanismsindiabetichearinglossandprovidenewideasindevelopinginterventionsandpreventingdamagescausedbydiabetes.

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简介：DiabetesMellitus(DM)isametabolicdisorderresultingfrommanyfactorsandcharacterizedbychronicelevatedbloodsugar.DM'scausesarenownotabsolutelyknown,butitisknownasasyndromeassociatedwithheredity,self-immuneandenvironmentalfactors.IntraditionalChinesemedicine,DMbelongstothecategoryof"XiaoKe"andistypedinto"ShangXiao',"ZhongXiao"and"XiaXiao"inthelightofthediseasedlocation.

简介：AbstractType 1 diabetes (T1D) is an autoimmune disease that resulted from the severe destruction of the insulin-producing β cells in the pancreases of individuals with a genetic predisposition. Genome-wide studies have identified HLA and other risk genes associated with T1D susceptibility in humans. However, evidence obtained from the incomplete concordance of diabetes incidence among monozygotic twins suggests that environmental factors also play critical roles in T1D pathogenesis. Epigenetics is a rapidly growing field that serves as a bridge to link T1D risk genes and environmental exposures, thereby modulating the expression of critical genes relevant to T1D development beyond the changes of DNA sequences. Indeed, there is compelling evidence that epigenetic changes induced by environmental insults are implicated in T1D pathogenesis. Herein, we sought to summarize the recent progress in terms of epigenetic mechanisms in T1D initiation and progression, and discuss their potential as biomarkers and therapeutic targets in the T1D setting.

简介：AbstractWith the increasing use of immune checkpoint inhibitors (ICI) including anti-cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1) in cancers, ICI-induced type 1 diabetes has been reported throughout the world. In this review, we aim to summarize the characteristics of this disease and discuss the mechanism of it. As an immune-related adverse event, type 1 diabetes developed after the administration of anti-PD-1 or anti-PD-ligand 1 (PD-L1) in the combination with or without anti-CTLA-4. It usually presented with acute onset, and 62.1% of the reported cases had diabetic ketoacidosis. Only a third of them had positive autoantibodies associated with type 1 diabetes. Susceptible HLA genotypes might be associated. T-cell-stimulation by blocking of the interaction of PD-1 and PD-L1 in pancreatic β cells was the main mechanism involved in the pathology. Insulin was the only effective treatment of ICI-induced type 1 diabetes. In conclusions, ICI-induced type 1 diabetes is a potentially life-threating adverse event after the immunotherapy of cancers. Screening and early recognition is important. Further investigation of the mechanism may help to better understand the pathology of type 1 diabetes.

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简介：AbstractPregnancy complicated with diabetes is associated with adverse maternal and fetal outcomes. Good control of glucose level during pregnancy contributes to improve maternal and fetal outcomes and break the vicious cycle of "diabetes begetting diabetes". The first line antidiabetic drug in pregnancy is insulin, which is expensive and inconvenient to use. Lots of clinical trials and meta-analyses have constantly confirmed the safety and efficacy of metformin in pregnancy. Several guidelines across the world have been discussing metformin as an alternative to insulin in pregnancy. This article summarizes the opinions about metformin from several latest guidelines.

简介：Medicaltherapyfortype2diabetesmellitusisineffectiveinthelongtermduetotheprogressivenatureofthedisease,whichrequiresincreasingmedicationdosesandpolypharmacy.Conversely,bariatricsurgeryhasemergedasacost-effectivestrategyforobesediabeticindividuals;ithaslowcomplicationratesandresultsindurableweightloss,glycemiccontrolandimprovementsinthequalityoflife,obesity-relatedco-morbidityandoverallsurvival.Thefindingthatglucosehomeostasiscanbeachievedwithaweightloss-independentmechanismimmediatelyafterbariatricsurgery,especiallygastricbypass,hasledtotheparadigmofmetabolicsurgery.However,theprimaryfocusofmetabolicsurgeryisthealterationofthephysio-anatomyofthegastrointestinaltracttoachieveglycemiccontrol,metaboliccontrolandcardio-metabolicriskreduction.Todate,metabolicsurgeryisstillnotwelldefined,asitisusedmostfrequentlyforlessobesepatientswithpoorlycontrolleddiabetes.Themechanismofglycemiccontrolisstillincompletelyunderstood.Publishedresearchfindingsonmetabolicsurgeryarepromising,butmanyaspectsstillneedtobedefined.Thispaperexaminestheproposedmechanismofdiabetesremission,theefficacyofdifferenttypesofmetabolicprocedures,thedurabilityofglucosecontrol,andtherisksandcomplicationsassociatedwiththisprocedure.Weproposeatailoredapproachfortheselectionoftheidealmetabolicprocedurefordifferentgroupsofpatients,consideringtheindicationsandprognosticfactorsfordiabetesremission.

简介：ObjectiveTostudyeffectsofJiangtangFanglongWan(glucose-loweringanddeafness-preventingcapsule)onhearinginananimalmodelofdiabetes.MethodsWistarratswereusedtocreateadiabetesmodelbyintraperitonealinjectionofstreptozotocin(STZ,55mg/kg).FortyratswererandomlyselectedtoreceiveJiangtangFanglongWan(10g/kg/day)throughintragastricgavage(treatmentgroup)ornormalsaline(controlgroup).Auditorybrainstemresponses(ABRs)wererecordedatMonths1,2and3.ResultsABRlatenciesandwaveintervalsweresimilarbetweenthetwogroupsatMonth1(P>0.05).ABRlatenciesandwaveintervalswereshorterinthetreatmentgroupthanthoseofthecontrolgroupatMonths2and3(P<0.05andP<0.01,respectively).ConclusionOurresultssuggestthatJiangtangFanglongWanmayhaveabeneficialeffectinpreventingandtreatinghearingimpairmentassociatedwithdiabetes.

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简介：<正>Thishighlightarticlefocusesontheeffectsofdifferenttypesofexerciseonthepreventionandtreatmentoftype2diabetesandonfuturechallengesindevelopingeffectivepreventivestrategies.1.CurrentprevalenceofdiabetesinChinaCardiovasculardiseaseshavebecometheleadingcauseofdeathinChina.DiabetesisamajorriskfactorforcardiovasculardiseasesandtherapidchangeinlifestyleisthemainreasonfortheincreasedriskforcardiovasculardiseasesinChina.TheChina

简介：AbstractBackground:Maturity-onset diabetes of the young (MODY) is the most common monogenic diabetes. The aim of this study was to assess the prevalence of MODY in phenotypic type 2 diabetes (T2DM) among Chinese young adults.Methods:From April 2015 to October 2017, this cross-sectional study involved 2429 consecutive patients from 46 hospitals in China, newly diagnosed between 15 years and 45 years, with T2DM phenotype and negative for standardized glutamic acid decarboxylase antibody at the core laboratory. Sequencing using a custom monogenic diabetes gene panel was performed, and variants of 14 MODY genes were interpreted as per current guidelines.Results:The survey determined 18 patients having genetic variants causing MODY (6 HNF1A, 5 GCK, 3 HNF4A, 2 INS, 1 PDX1, and 1 PAX4). The prevalence of MODY was 0.74% (95% confidence interval [CI]: 0.40-1.08%). The clinical characteristics of MODY patients were not specific, 72.2% (13/18) of them were diagnosed after 35 years, 47.1% (8/17) had metabolic syndrome, and only 38.9% (7/18) had a family history of diabetes. No significant difference in manifestations except for hemoglobin A1c levels was found between MODY and non-MODY patients.Conclusion:The prevalence of MODY in young adults with phenotypic T2DM was 0.74%, among which HNF1A-, GCK-, and HNF4A-MODY were the most common subtypes. Clinical features played a limited role in the recognition of MODY.