Metabolic Dysfunction–Associated Steatotic Liver Disease

Annals of Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Янв. 13, 2025

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic in United States. It characterized by steatosis and potentially reversible. Risk factors include obesity, type 2 mellitus, other metabolic disorders. steatohepatitis (MASH), a more severe form of MASLD, puts patients at risk for cirrhosis, decompensation, cancer. Diet, exercise, weight loss are cornerstones management. Although only 1 medication has been approved treatment MASH, pharmacotherapies surgeries that aid optimize can be used. Early diagnosis intervention important to prevent progression cirrhosis its complications, including

Язык: Английский

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Hemochromatosis

Annals of Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Фев. 10, 2025

Hemochromatosis is an inheritable condition that mainly affects White populations of European descent. Most patients remain asymptomatic, but others develop advanced organ damage reduces quality life and long-term survival. Arthropathy, diabetes mellitus, cirrhosis, hypogonadotropic hypogonadism, cardiomyopathy are key clinical manifestations. Primary care hospital medicine physicians play essential role in early identification this disease, which can be accomplished via standard hematologic testing. Early diagnosis therapeutic phlebotomy improve outcomes.

Язык: Английский

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Glucagon-Like Peptide-1 Receptor Agonists and Risk for Depression in Older Adults With Type 2 Diabetes

Annals of Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Фев. 24, 2025

Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown potential antidepressant effects, population studies yield inconsistent results. To compare the risk for depression in older adults with type 2 diabetes (T2D) initiating treatment GLP-1RAs versus sodium-glucose cotransporter-2 inhibitors (SGLT2is) or dipeptidyl peptidase-4 (DPP4is). Target trial emulation study. U.S. National Medicare administrative data from January 2014 to December 2020. Adults aged 66 years T2D a GLP-1RA were matched 1:1 on propensity score those either an SGLT2i DPP4i. The primary end point was incident depression. Cox proportional hazards regression models used estimate hazard ratio (HR) 95% CI within groups. A total of 14 665 pairs included cohort SGLT2is; rate difference between users and 3.48 (95% CI, -0.81 7.78) per 1000 person-years, HR 1.07 (CI, 0.98 1.18). In DPP4is (13 711 pairs), -5.78 -10.49 -1.07) 0.90 0.82 0.98). Unmeasured confounders (such as hemoglobin A1c levels body mass index), outcome misclassification, limited generalizability all (for example, younger populations without receiving drug obesity treatment). Among T2D, incidence relatively low. Use associated modestly lower compared use DPP4is, but not SGLT2is. Institute Diabetes Digestive Kidney Diseases Institutes Health.

Язык: Английский

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Extracellular matrix promotes diabetic oral wound healing by modulating the microenvironment

Biomaterials Research, Год журнала: 2025, Номер 29

Опубликована: Янв. 1, 2025

Oral wounds in diabetes mellitus (DM) often delay healing due to reduced angiogenesis and increased inflammatory response the local microenvironment, even leading graft necrosis implant failure. Therefore, developing an effective program promote is of great clinical value. Much current research focused on promoting wound through surface adhesive materials that exert a pro-angiogenic, anti-inflammatory effect. However, application bonding oral cavity very limited humid friction-prone environment. Decellularized extracellular adipose tissue (DAT) easily accessible biocompatible material derived from tissue. To further explore potential DAT, we used multi-omics analyze its composition possible mechanisms. Proteomic studies revealed DAT contains anti-inflammatory, pro-angiogenic proteins DM regeneration. adapt moist chewing friction environment mouth, modified into temperature-sensitive hydrogel can be injected intramucosally. has been verified effects macrophage phenotypic transformation. Meanwhile, transcriptome analysis suggested inhibitory effect interleukin 17 signaling pathway might key factor healing. In conclusion, after multi-omic analysis, good adapted specific cavity. This provides way setting.

Язык: Английский

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Unifying Efforts to Empower Equitable Obesity Care: Synopsis of an American College of Physicians and Council of Subspecialty Societies Summit

Annals of Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 31, 2025

Obesity is a leading cause of morbidity and mortality with health consequences that crosscut most medical specialties. Despite the emergence effective promising new therapies, many impediments to comprehensive obesity care remain. As part their commitment improving care, American College Physicians (ACP) its Council Subspecialty Societies (CSS) held summit on 24 October 2023 identify barriers opportunities for collaborative action in domains physician education, policy delivery, addressing weight bias. This report summarizes proceedings provides postsummit synthesis from ACP CSS. Key themes were centered knowledge, advocacy, action, compassion, including need culture change, paradigm shifts, stakeholder engagement collaboration; focus empowerment both clinicians patients; importance knowing patients as people help address social determinants health; learned helplessness; embracing artificial intelligence technology disruptive innovations. Recommendations next steps include leveraging already available educational clinical resources, developing education standards incorporate patients' perspectives health, community public–private partnerships improve access public awareness, coordinating messaging advocacy efforts align mitigating longstanding epidemic.

Язык: Английский

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Association between dietary patterns and glycemic control in type II diabetes mellitus patients

Atención Primaria, Год журнала: 2024, Номер 57(2), С. 103075 - 103075

Опубликована: Сен. 16, 2024

Язык: Английский

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Role of the liver in the sustained normalisation of A1c over 2 years following short‐term insulin therapy in early type 2 diabetes

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 28, 2024

Abstract Aims When administered in early type 2 diabetes (T2DM), the strategy of ‘induction’ with short‐term intensive insulin therapy (IIT) followed by ‘maintenance’ metformin thereafter can yield outstanding glycaemic control, some patients achieving A1c normal range its assay. We thus sought to identify determinants sustained normalisation response this treatment strategy. Materials and Methods In study, adults T2DM mean duration 1.7 ± 1.4 years received induction IIT (glargine, lispro) for 3 weeks, maintenance either or without periodic 2‐week courses every months years. Sustained was defined <6.0% at Results Of 101 participants, 26 achieved At baseline, these individuals had lower fasting glucose than other along better beta‐cell function. During from weeks years, they greater reduction adiposity (body mass index: p = 0.02; waist circumference: 0.02), hepatic resistance (HOMA‐IR: 0.02) ALT ( 0.005), coupled relative stabilisation function glycaemia. On logistic regression analyses, significant independent predictors were baseline (adjusted odds ratio [aOR] 0.01 [95% CI 0.001–0.16], 0.001) changes circumference (aOR 0.77 [0.63–0.94], 0.012) 0.90 [0.82–0.98], 0.019) during Conclusions While central predicted as anticipated, emergence a concomitant determinant highlights role liver achievement normalisation.

Язык: Английский

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Effectiveness and mechanisms of sodium-dependent glucose transporter 2 inhibitors in type 2 diabetes and heart failure patients

World Journal of Cardiology, Год журнала: 2024, Номер 16(10), С. 611 - 615

Опубликована: Окт. 17, 2024

We comment on an article by Grubić Rotkvić

Язык: Английский

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