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Type 2 Diabetes: Epidemiology and Clinical Advances

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Dr. Abdallah Al-Salameh

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1. Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, F-80054 Amiens, France
2. PériTox UMR-I 01, University of Picardie Jules Verne, Chemin du Thil, F-80025 Amiens, France
Interests: diabetes; endocrinology; hyperaldosteronism; paraganglioma; pheochromocytoma; multiple endocrine neoplasia

Special Issue Information

Dear Colleagues,

The global diabetes prevalence in adults was estimated at 10.5% in 2021 and it is predicted to rise to 12.2% in 2045. The prevalence of diabetes and the occurrence of its complications differ by country, race and ethnicity, sex and socioeconomic level. During the last decade, advances in the treatment of type 2 diabetes, the most frequent type of diabetes, have been spectacular. The introduction and widespread use of glucose-lowering drugs with cardiovascular benefits (glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors) are expected to modify the history of diabetes. However, disparities in the prevalence of diabetes or the occurrence of its complications still exist and as the prevention and treatment of cardiovascular complications improve, other complications will come to the fore. This includes diabetic foot ulcers, vascular dementia, periodontitis and some cancers. The main aim of this Special Issue is to provide an update on the changing epidemiology of diabetes and its complications and the impact of the newer glucose-lowering drugs on the natural history of diabetes and its complications. Papers about persistent disparities in the prevalence of diabetes and complications and those about the less studied complications (peripheral artery disease, diabetic foot ulcers, vascular dementia, chronic periodontitis, cancer and infections) are most welcomed.

Dr. Abdallah Al-Salameh
Guest Editor

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Research

14 pages, 971 KiB

Open AccessArticle

Early Clinical Experience of Finerenone in People with Chronic Kidney Disease and Type 2 Diabetes in Japan—A Multi-Cohort Study from the FOUNTAIN (FinerenOne mUltidatabase NeTwork for Evidence generAtIoN) Platform

by Atsuhisa Sato, Daloha Rodriguez-Molina, Kanae Yoshikawa-Ryan, Satoshi Yamashita, Suguru Okami, Fangfang Liu, Alfredo Farjat, Nikolaus G. Oberprieler, Csaba P. Kovesdy, Keizo Kanasaki and David Vizcaya

J. Clin. Med. 2024, 13(17), 5107; https://doi.org/10.3390/jcm13175107 - 28 Aug 2024

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Abstract

Background: In the phase 3 clinical trials FIGARO-DKD and FIDELIO-DKD, finerenone reduced the risk of cardiovascular and kidney events among people with chronic kidney disease (CKD) and type 2 diabetes (T2D). Evidence regarding finerenone use in real-world settings is limited. Methods: A retrospective cohort study (NCT06278207) using two Japanese nationwide hospital-based databases provided by Medical Data Vision (MDV) and Real World Data Co., Ltd. (RWD Co., Kyoto Japan), converted to the OMOP common data model, was conducted. Persons with CKD and T2D initiating finerenone from 1 July 2021, to 30 August 2023, were included. Baseline characteristics were described. The occurrence of hyperkalemia after finerenone initiation was assessed. Results: 1029 new users of finerenone were included (967 from MDV and 62 from RWD Co.). Mean age was 69.5 and 72.4 years with 27.3% and 27.4% being female in the MDV and RWD Co. databases, respectively. Hypertension (92 and 95%), hyperlipidemia (59 and 71%), and congestive heart failure (60 and 66%) were commonly observed comorbidities. At baseline, 80% of persons were prescribed angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers. Sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists were prescribed in 72% and 30% of the study population, respectively. The incidence proportions of hyperkalemia were 2.16 and 2.70 per 100 persons in the MDV and RWD Co. databases, respectively. There were no hospitalizations associated with hyperkalemia observed in either of the two datasets. Conclusions: For the first time, we report the largest current evidence on the clinical use of finerenone in real-world settings early after the drug authorization in Japan. This early evidence from clinical practice suggests that finerenone is used across comorbidities and comedications. Full article

(This article belongs to the Special Issue Type 2 Diabetes: Epidemiology and Clinical Advances)

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11 pages, 627 KiB

Open AccessArticle

Skin Microvascular Dysfunction in Type 2 Diabetes Mellitus Using Laser Speckle Contrast Analysis and Association with Carotid Intima-Media Thickness

by Stamatina Lamprou, Nikolaos Koletsos, Ioanna Zografou, Antonios Lazaridis, Gesthimani Mintziori, Christina Maria Trakatelli, Vasilios Kotsis, Eugenia Gkaliagkousi, Michael Doumas and Areti Triantafyllou

J. Clin. Med. 2024, 13(16), 4957; https://doi.org/10.3390/jcm13164957 - 22 Aug 2024

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Abstract

Background: It is established that diabetes mellitus (DM) is characterized by increased cardiovascular risk associated with subclinical atherosclerosis as well as microvascular alterations. Laser speckle contrast analysis (LASCA) is an innovative, non-invasive method for assessing skin microvascular function. Objectives: We sought to assess skin microvascular function in patients with type 2 DM and matched controls. Methods: Consecutive patients with DM and individuals matched for age, sex and BMI were included in the study. Skin microvascular perfusion was assessed, using LASCA, during baseline, a 5 min occlusion period and a 5 min reperfusion period. Carotid intima-media thickness (cIMT) was measured as a surrogate marker of macrocirculation. Results: In total, 18 patients with DM and 22 in the control group were enrolled. No statistically significant differences were observed in baseline flux, peak flux and percentage decrease during arterial occlusion. During reperfusion, individuals with DM exhibited a smaller peak magnitude compared to controls (147.0 ± 64.7% vs. 189.4 ± 46.0%, respectively; p < 0.05). Moreover, cIMT was higher in patients with DM compared to controls (0.68 ± 0.09 mm vs. 0.60 ± 0.08 mm, respectively, p < 0.01) and was negatively correlated with skin microvascular reactivity in the univariate analysis. In the multivariate analysis, glucose and office systolic blood pressure levels remained significant predictors of microvascular reactivity. Conclusions: Our study shows that patients with type 2 DM exhibit impaired skin microvascular function compared to controls. Furthermore, glucose levels and blood pressure play a key role in microvascular dysfunction. However, additional studies are needed to address the clinical significance of early microvascular changes in DM. Full article

(This article belongs to the Special Issue Type 2 Diabetes: Epidemiology and Clinical Advances)

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